One-and-a-Half Syndrome, Facial Palsy, and Nystagmus Due to Dorsal Pontine Demyelination
Creator
Daniel R. Gold, DO
Affiliation
(DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
This is a 16-yo-girl with oscillopsia and double vision. Exam showed inability to look to the left with either eye due to left nuclear 6th. There was also a left INO (horizontal gaze palsy + INO = one-and-a-half syndrome) from left MLF involvement and left lower motor neuron facial palsy due to fascicular 7th nerve involvement. One-and-a-half syndrome + facial (7th) palsy = "eight-and-a-half syndrome". There was also upbeat-torsional nystagmus, presumably due to involvement of the vertical semicircular canal pathways (mainly involving the anterior pathways given downward slow and upward fast phase). The anterior canal pathways travel through the superior conjunctivum, ventral tegmental tract, and MLF, whereas the posterior canal pathways travel through the MLF only.
Date
2016
Language
eng
Format
video/mp4
Type
Image/MovingImage
Collection
Neuro-Ophthalmology Virtual Education Library: Dan Gold Neuro-Ophthalmology Collection: https://novel.utah.edu/Gold/
Publisher
North American Neuro-Ophthalmology Society
Holding Institution
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5890