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One-and-a half syndrome is seen in paramedian pontine lesions, and may also co-exist with cranial nerve paralysis. This clinical situation is called eight-anda-half syndrome when facial nerve paralysis also accompanies this manifestation. A man aged 38 years was admitted with symptoms of sudden-onset binocular diplopia and dizziness. The patient had no known co-morbidities. Cranial magnetic resonance imaging showed a small-sized infarct in the left paramedian pontine tegmentum posterior area. In his neuro-ophthalmologic examination, total paresis of left eye horizontal movements, mild lateral deviation, and monocular nystagmus during abduction of the right eye were observed. The patient also had peripheral facial paralysis on the left side; therefore, no signs of motor deficit of his extremities were examined. Eight-and-a-half syndrome is a rare disorder that is seen in localized-small pons lesions, mostly accompanied by infarcts. This clinical manifestation is called eight-and-a-half syndrome and arises within lesions in both the parapontine reticular formation and the medial longitudinal fasciculus in the inferior pons tegmentum where horizontal eye movements are controlled, and facial axons adjacent to the nucleus of the sixth nerve. We wanted to present this case to emphasize this rare situation. Keywords:One-and-a-half syndrome, facial palsy, pontin lesion Paramedyan pontin lezyonlarında görülen bir buçuk sendromu, kraniyal sinir paralizileri ile birlikte de görülebilir. Fasiyal sinir paralizisi ile birlikte görülen klinik tablo sekiz buçuk sendromu olarak adlandırılır. Otuz sekiz yaşında erkek hasta, ani başlayan çift görme, baş dönmesi şikayetleriyle başvurdu. Bilinen komorbiditesi olmayan hastanın çekilen kraniyal manyetik rezonans görüntülerinde difüzyon ağırlıklı kesitlerinde sol paramedyan pontin tegmentum posterior kesimde küçük bir enfarkt alanı görüldü. Nöro-oftalmolojik muayenesinde sol göz horizontal göz hareketlerinde tam parezi, sağ göz primer pozisyonda hafif laterale deviasyon ile addüksiyon kısıtlılığı ve dışa bakış sırasında ortaya çıkan nistagmus görüldü. Ekstremitelerinde motor defisite rastlanmayan hastada solda periferik tipte fasiyal paralizi saptandı. Bir buçuk sendromu iyi lokalize küçük pons lezyonlarında, en sık olarak enfarktlar ile birlikte tanımlanmış nadir bir tablodur. Horizontal göz hareketlerinin düzenlendiği inferior pons tegmentumundaki paramedyan pontin retiküler formasyon, mediyal longitidunal fasikül ve altıncı kraniyal sinir nükleusu ile hemen komşuluğundaki fasiyal sinir aksonlarını tutan lezyonlar ile ortaya çıkan klinik tablo sekiz buçuk sendromu olarak adlandırılır. Literatürde nadir olarak bildirilmiş bu durumu vurgulamak için olguyu sunmak istedik.Anahtar Kelimeler: Bir buçuk sendromu, fasiyal paralizi, pons lezyonu Abstract ÖzAd dress for Cor res pon den ce/Ya z›fl ma Ad re si: Esra Eruyar MD,

Background: Quantitative MRI assessment methods have limited utility due to a lack of standardized methods and measures for Alzheimer disease (AD) and amnestic mild cognitive impairment (aMCI). Objective: To employ a relatively new and easy-to-use quantitative assessment method to reveal volumetric changes in subcortical gray matter (GM) regions, hippocampus, and global intracranial structures as well as the diagnostic performance and best thresholds of total hippocampal volumetry in individuals with AD and those with aMCI. Method: A total of 74 individuals—37 with mild to moderate AD, 19 with aMCI, and 18 with normal cognition (NC)—underwent a 3T MRI. Fully automated segmentation and volumetric measurements were performed. Results: The AD and aMCI groups had smaller volumes of amygdala, nucleus accumbens, and hippocampus compared with the NC group. These same two groups had significantly smaller total white matter volume than the NC group. The AD group had smaller total GM volume compared with the aMCI and NC groups. The thalamus in the AD group showed a subtle atrophy. There were no significant volumetric differences in the caudate nucleus, putamen, or globus pallidus between the groups. Conclusion: The amygdala and nucleus accumbens showed atrophy comparable to the hippocampal atrophy in both the AD and aMCI groups, which may contribute to cognitive impairment. Hippocampal volumetry is a reliable tool for differentiating between AD and NC groups but has substantially less power in differentiating between AD and aMCI groups. The loss of total GM volume differentiates AD from aMCI and NC.