A Rare Multinuclear Lesion Secondary to Multifactorial Ischemic Stroke: A Case Report on Eight-and-a-Half Syndrome.

Brandon Vander Zee, Omar Zineldine, Lien Diep-Plagie
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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.

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继发于多因素缺血性中风的罕见多核病变:八点半综合征病例报告
核内眼球震颤症(INO)是一种水平眼球运动障碍,与内侧纵筋膜(MLF)的病变有关。当病变累及 MLF 和同侧的外展神经核或脑桥背内侧被盖中的脑桥旁网状结构(PPRF)时,就会出现一侧半综合征。当病变足够大时,面神经束(CNVII)也会受累,导致同侧面神经麻痹。如果合并一侧半综合征(one-and-a-half syndrome),这种情况就会变成一侧半综合征(eightand-a-half syndrome,EHS)。在此,我们描述了一例独特的 EHS 病例,患者是一名 72 岁的男性,具有多种缺血性卒中危险因素,表现为 INO、共轭凝视麻痹、同侧面神经麻痹和一过性对侧偏瘫。认识到这种神经功能缺损模式有助于病变的定位,防止贝尔氏麻痹的误诊,并加快正确的治疗。
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