University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
Johns Hopkins University Medical Institution, Baltimore, Maryland.
S D Med. 2024 Jun;77(6):248-250.
Internuclear ophthalmoparesis (INO) is a horizontal eye movement disorder that is associated with a lesion at the medial longitudinal fasciculus (MLF). One-and-a-half syndrome occurs when the lesion involves the MLF and the ipsilateral abducens nuclei or the paramedian pontine reticular formation (PPRF) in the dorsomedial tegmentum of the pons. When the lesion is large enough, the fascicles of the facial nerve (CNVII) can also be involved, resulting in an ipsilateral facial nerve palsy. In combination with one-and-a-half syndrome, this condition becomes eightand- a- half syndrome (EHS). Here, we describe a unique case of EHS in a 72-year-old male with multiple ischemic stroke risk factors who presented with INO, conjugate gaze palsy, ipsilateral facial palsy, and a transient contralateral hemiparesis. Recognizing this pattern of neurologic deficits improves localization of the lesion, prevents misdiagnosis of Bell's Palsy, and expedites proper treatment.
核间性眼肌麻痹（INO）是一种与内侧纵束（MLF）病变相关的水平眼球运动障碍。当病变累及 MLF 及其同侧展神经核或桥脑背内侧被盖的旁正中网状结构（PPRF）时，会出现 1.5 综合征。当病变足够大时，面神经（CNVII）的束也可能受累，导致同侧面神经麻痹。与 1.5 综合征结合，这种情况成为 8.5 综合征（EHS）。在这里，我们描述了一名 72 岁男性的 EHS 独特病例，该男性有多种缺血性中风危险因素，表现为 INO、共轭凝视麻痹、同侧面瘫和短暂的对侧偏瘫。认识到这种神经缺陷模式可改善病变的定位，防止贝尔氏面瘫的误诊，并加快适当的治疗。
