J Korean Neurol Assoc.
1988 Dec;6(2):191-201.
One-and-a-half Syndrome: A Clinicoradiological Study of 7 cases
- Affiliations
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- 1Department of neurology, College of medicine, Seoul National University.
Abstract
- 'One-and-a-half syndrome' is an unusual clinical disorder of extraocular movement characterized by a lateral conjugate palsy in a direction with an internuclear ophthalmoplegia in the other direction. The authors reviewed 7 casese of 'one-and-a-half syndrome' confirmed by Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) of the brain. Analysis of these cases led us to conclude; 1. The cause was brainstem infarction in 3 cases, presumed infarction in one (no evidence of bleeding in CT), pontine hemorrhage in 2 and primary intraventricular hemorrhage in one. 2. Presenting symptom was diplopia in 5, dizziness or vertigo in 3, and swallowing difficulty in 3. 3. Longterm follow-up revealed that unilateral or bilateral INO gradually replaced the 'one-and-a-half syndrome'. 4. In three cases of brainstem infarction, MRI clearly demonstrated the lesion which initial CT scanning had failed to detect. 5. With the growing of utilization of MRI, we can anticipate the better elucidation of etiology and more detailed anatomical localization.
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