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One and a half syndrome
The one and a half syndrome is a rare cause of ophthalmoparesis characterized by "a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other".[1] The most common manifestation of this unusual syndrome is limitation of horizontal eye movement to abduction of one eye with no horizontal movement of the other eye. Convergence is classically spared as Cranial Nerve III (oculomotor nerve) and its nucleus is spared bilaterally. Additional recommended knowledge
AnatomyThe syndrome usually results from a single unilateral lesion of the paramedian pontine reticular formation which also involves the ipsilateral medial longitudinal fasciculus. An alternative anatomical cause is a lesion of the abducens nucleus on one side, with interruption of the ipsilateral medial longitudinal fasciculus after it has crossed the midline from its site of origin in the contralateral abducens nucleus (resulting in a failure of adduction of the ipsilateral eye). CausesCauses of the one and a half syndrome include pontine hemorrhage, ischemia, tumors, infective mass lesions such as tuberculomas, and demyelinating conditions like multiple sclerosis. TreatmentThere have been cases of improvement in extra-ocular movement with botulinum toxin injection.[2] References
Categories: Neurology | Medical signs |
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This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "One_and_a_half_syndrome". A list of authors is available in Wikipedia. |