Eight-and-a-half syndrome: a rare presentation

Ingle, Vaibhav; Panda, Smritimayee; Penuboina, Tejaswini; Kashyap, Manshi

doi:10.1136/bcr-2021-244338

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…[6] In addition to the classic dorsolateral medullary syndrome and the eight-and-a-half syndromes, we should also pay attention to the superimposed brainstem syndrome and its variants which are easy to miss due to the need for detailed cranial nerve examination, such as oculomotor examination. [4,16] Therefore, it is important to recognize the features of the classical brainstem syndrome and the eight-and-a-half syndromes in order to localize the lesion and determine the appropriate treatment plan. [17] This case highlights the importance of bedside examination and the ability to correlate clinical findings with known brainstem Neuroanatomy to help select the examination.…”

Section: Discussionmentioning

confidence: 99%

Case report: Lateral medullary syndrome with eight-and-a-half syndromes

Zuo,

Zhao,

Zhao

et al. 2024

Medicine

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Rationale: Lateral medullary syndrome is caused by atherosclerosis or embolism of the vertebral artery and its branches or the posterior inferior cerebellar artery (PICA).The eight-and-a-half syndrome is a rare pontocerebellar nerve-ocular syndrome presenting as a one-and-a-half syndrome plus ipsilateral seventh cerebral nerve palsy. The dorsolateral medullary syndrome combined with the eight-and-a-half syndromes is even rarer, so it is important to recognize the features of the classical brainstem syndrome and the eight-and-a-half syndromes. Patient concerns: Most patients with dorsolateral medullary syndrome combined with eight-and-a-half syndromes have a good prognosis, with recovery occurring within a few weeks to a few months, although a few patients may take longer to recover. Diagnosis interventions: In the course of disease development, the patient developed dysarthria, dysphagia, hypothermia, ipsilateral Horner sign and ataxia. Computed tomography was performed which showed cerebral infarction in the left brainstem. Cranial diffusion-weighted imaging + magnetic resonance angiography showed acute infarction in the left cerebellar hemisphere, with a high probability of severe stenosis or occlusion in the intracranial and proximal segments of the basilar arteries. This supports the diagnosis of dorsolateral medullary syndrome. The patient’s limited adduction and abduction of the left eye and limited adduction of the right eye, combined with peripheral paralysis of the affected lateral nerve, supported the diagnosis of eight-and-a-half syndromes. The administration of antiplatelet and anti-ester fixation treatment can effectively improve the symptoms and shorten the course of the disease. Outcomes: After antiplatelet and anti-ester fixation treatment, the symptoms improved and the patient was discharged. Lessons: Dorsolateral medullary syndrome combined with eight-and-a-half syndromes is a rare clinical condition, and therefore more attention should be paid to the early diagnosis and treatment of such patients.

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Section: Discussionmentioning

confidence: 99%

Case report: Lateral medullary syndrome with eight-and-a-half syndromes

Zuo,

Zhao,

Zhao

et al. 2024

Medicine

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Neuromyelitis Optica Spectrum Disorder Coexisting with Primary Sjogren's Syndrome and Primary Biliary Cholangitis: A Case Report and literature review

Jia,

Feng,

Wang

et al. 2024

Neuroimmunology Reports

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Eight-and-a-half syndrome – A rare presentation of pontine infarction

Lavanya,

Abbigeri,

Turadagi

2023

Indian Journal of Ophthalmology - Case Reports

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Eight-and-a-half syndrome is clinically characterized by conjugate gaze palsy and internuclear ophthalmoplegia along with lower motor neuron type facial nerve palsy. Usually, it occurs because of infarction or demyelinating disease at paramedian tegmentum of lower pons. It emphasizes the importance of checking ocular movements. A 55-year-old male patient presented with sudden onset of double vision, headache, and vomiting and found to have horizontal gaze palsy, internuclear ophthalmoplegia, and facial palsy of the left side. High blood pressure was noted. Clinically, eight and a half syndrome was identified. MRI brain showed infarct at pons. The patient was stabilized systemically. A detailed clinical neuro-ophthalmic examination, along with a clear understanding of the neuro-anatomical pathways, gives clinicians a good diagnostic opportunity to localize precisely lesions in the brainstem. The disease should be evaluated for etiology.

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Eight-and-a-half syndrome: a rare presentation

Cited by 3 publications

References 12 publications

Case report: Lateral medullary syndrome with eight-and-a-half syndromes

Case report: Lateral medullary syndrome with eight-and-a-half syndromes

Neuromyelitis Optica Spectrum Disorder Coexisting with Primary Sjogren's Syndrome and Primary Biliary Cholangitis: A Case Report and literature review

Eight-and-a-half syndrome – A rare presentation of pontine infarction

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