Bilateral Horizontal Gaze Palsy with Unilateral Peripheral Facial Paralysis Caused by Pontine Tegmentum Infarction

Felı́cio, André Carvalho; Bichuetti, Denis Bernardi; Marin, Luís Fabiano; Santos, William Adolfo Celso dos; Godeiro-Júnior, Clécio

doi:10.1016/j.jstrokecerebrovasdis.2008.10.008

Cited by 22 publications

(15 citation statements)

References 6 publications

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“…The prime etiologies for both syndromes are brain stem infarcts/hemorrhage, multiple sclerosis/brainstem demyelination,[ 5 ] brain stem tumors, and arteriovenous malformations. [ 6 ] There are few new variants of eight-and-a-half syndrome. An elderly patient with acute dorsal pontine infarction developed bilateral horizontal gaze palsy due to involvement of bilateral abducens nucleus/PPRF with unilateral peripheral facial paralysis due to anterior extension of the vascular lesion reaching facial nerve fascicle.…”

Section: Discussionmentioning

confidence: 99%

“…An elderly patient with acute dorsal pontine infarction developed bilateral horizontal gaze palsy due to involvement of bilateral abducens nucleus/PPRF with unilateral peripheral facial paralysis due to anterior extension of the vascular lesion reaching facial nerve fascicle. [ 6 ] Lee et al ., (2007) described a new variant in an elderlypatient with bilateral facial palsy and complete loss of vertical saccades and pursuit with bilateral horizontal gaze palsy. [ 7 ] A case of eight-and-a-half syndrome, combined with ipsilateral vertical gaze palsy was reported by Marquart et al ., (2013) due to involvement of midbrain reticular formation apart from dorsal pontine tegmentum.…”

Section: Discussionmentioning

confidence: 99%

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"Nine" syndrome: A new neuro-ophthalmologic syndrome: Report of two cases

Mahale

Mehta

John

et al. 2015

Ann Indian Acad Neurol

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“Eight-and-a-half” syndrome is a rare condition involving the ipsilateral abducens nucleus or paramedian pontine reticular formation (PPRF), the ipsilateral medial longitudinal fasciculus (MLF), and the adjacent facial colliculus/facial nerve fascicle. The condition is often caused by a lesion (vascular or demyelinating) in the dorsal tegmentum of the caudal pons. There are new variants of this syndrome caused by extension of lesion to involve new adjacent structures in pontine tegmentum. We report two patients with different etiology presenting with clinical features suggestive of eight-and-a-half syndrome associated with hemiataxia representing “nine” syndrome (8½ + ½ = 9) adding new dimension to “eight-and-a-half” syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

"Nine" syndrome: A new neuro-ophthalmologic syndrome: Report of two cases

Mahale

Mehta

John

et al. 2015

Ann Indian Acad Neurol

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“… 26 Bilateral horizontal gaze palsy is rare in occurrence and characteristic of tegmental pontine infarctions. 29 …”

Section: Visual Stroke Syndromesmentioning

confidence: 99%

Eyes and stroke: the visual aspects of cerebrovascular disease

Pula

Yuen

2017

Stroke Vasc Neurol

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A large portion of the central nervous system is dedicated to vision and therefore strokes have a high likelihood of involving vision in some way. Vision loss can be the most disabling residual effect after a cerebral infarction. Transient vision problems can likewise be a harbinger of stroke and prompt evaluation after recognition of visual symptoms can prevent future vascular injury. In this review, we discuss the visual aspects of stroke. First, anatomy and the vascular supply of the visual system are considered. Then, the different stroke syndromes which involve vision are discussed. Finally, topics involving the assessment, prognosis, treatment and therapeutic intervention of vision-specific stroke topics are reviewed.

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“…Among these, when bilateral abducens nucleus was involved, BHGP without OCR may develop. [6][7][8][9][10]13,16,17 Furthermore, the facial nerve can be involved unilaterally 7,8,10,12,16 or bilaterally 14,17 in cases of acquired BHGP, because it is running in the vicinity of the abducens nucleus.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Horizontal Gaze Paresis as an Initial Manifestation of Wernicke Encephalopathy

Tsuda

Kageyama

Tanaka

et al. 2012

Neuro-Ophthalmology

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A 62-year-old man with hypertension, diabetes mellitus and alcoholic chronic pancreatitis developed bilateral horizontal gaze paresis (BHGP) with convergence paralysis. He declared that alcohol intake was given up for 4 years. Cranial magnetic resonance imaging (MRI) findings were normal. Tiny pontine infarction was suspected. However, 5 days later, confusional status and bilateral total external ophthalmoplegia appeared. MRI demonstrated typical findings of Wernicke encephalopathy (WE). Decreased blood thiamine level was confirmed. Neurological symptoms and MRI findings rapidly normalized under intravenous thiamine therapy. He confessed his alcohol abuse. This is a first reported case of BHGP as an initial manifestation of WE.

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Bilateral Horizontal Gaze Palsy with Unilateral Peripheral Facial Paralysis Caused by Pontine Tegmentum Infarction

Cited by 22 publications

References 6 publications

"Nine" syndrome: A new neuro-ophthalmologic syndrome: Report of two cases

"Nine" syndrome: A new neuro-ophthalmologic syndrome: Report of two cases

Eyes and stroke: the visual aspects of cerebrovascular disease

Bilateral Horizontal Gaze Paresis as an Initial Manifestation of Wernicke Encephalopathy

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