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

BMJ Case Rep. 2021 Sep 3;14(9):e244338. doi: 10.1136/bcr-2021-244338.

Abstract

Eight-and-a-half syndrome is a rare entity characterised by conjugate horizontal gaze palsy, ipsilateral internuclear ophthalmoplegia and ipsilateral lower motor neuron type facial palsy. It is due to a lesion affecting median longitudinal fasciculus, paramedian pontine reticular formation and facial nerve fascicle on the same side at the level of pons. The diagnosis is easily missed as it needs detailed ocular movement examination. It is mainly caused due to infarction or demyelinating conditions. We are reporting an interesting case of a 54-year-old man with right-side eight-and-a-half syndrome due to acute ischaemic stroke and ST-elevation myocardial infarction of the inferior wall.

Keywords: brain stem / cerebellum; ischaemic heart disease; stroke.

Publication types

  • Case Reports

MeSH terms

  • Brain Ischemia*
  • Facial Paralysis* / etiology
  • Humans
  • Male
  • Middle Aged
  • Ocular Motility Disorders* / diagnosis
  • Ocular Motility Disorders* / etiology
  • Ophthalmoplegia* / diagnosis
  • Ophthalmoplegia* / etiology
  • Pons / diagnostic imaging
  • Stroke* / diagnosis
  • Stroke* / etiology