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J Stroke Cerebrovasc Dis. 2013 Nov;22(8):e637-8. doi: 10.1016/j.jstrokecerebrovasdis.2013.01.018. Epub 2013 Feb 21.

Eight and a half syndrome with hemiparesis and hemihypesthesia: the nine syndrome?

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Eye Tracking & Visual Application Lab, Department of Neurological, Neurosurgical, and Behavioral Sciences, Siena, Italy.


"Eight-and-a-half" syndrome is "one-and-a-half" syndrome (conjugated horizontal gaze palsy and internuclear ophthalmoplegia) plus ipsilateral fascicular cranial nerve seventh palsy. This rare condition, particularly when isolated, is caused by circumscribed lesions of the pontine tegmentum involving the abducens nucleus, the ipsilateral medial longitudinal fasciculus, and the adjacent facial colliculus. Its recognition is therefore of considerable diagnostic value. We report a 71-year-old man who presented with eight and a half syndrome associated with contralateral hemiparesis and hemihypesthesia, in which brain magnetic resonance imaging scans revealed a lacunar pontine infarction also involving the corticospinal tract and medial lemniscus. These features could widen the spectrum of pontine infarctions, configuring a possible "nine" syndrome.


Acute pontine stroke; neuro-ophthalmology; neuroimaging

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