Abstract:
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.
摘要:
核内眼瘫(INO)是一种水平眼运动障碍,与内侧纵向束(MLF)的病变有关。当病变涉及MLF和同侧外展核或脑桥背侧被膜的旁正中网状结构(PPRF)时,就会发生一个半综合症。当病变足够大时,面神经的束(CNVII)也可以参与,导致同侧面神经麻痹.结合了一个半综合症,这种情况成为八半综合征(EHS)。这里,我们描述了一个独特的EHS病例,在72岁的男性中,有多个缺血性卒中危险因素,共轭凝视麻痹,同侧面神经麻痹,和短暂的对侧偏瘫。认识到这种神经缺陷的模式可以改善病变的定位,防止贝尔麻痹的误诊,并加快适当的治疗。