Abstract
Three cases of isolated one-and-a-half syndrome with facial nerve palsy related to infarction are presented. Magnetic resonance imaging in cases 1 and 2 was unremarkable, whereas magnetic resonance angiography demonstrated pathophysiologically significant vertebral basilar disease. Case 3 is unique due to its association with giant cell arteritis. Ipsilateral adduction improved to a greater extent than abduction in each case, perhaps providing insight into the exact localization of these lesions or selective vulnerability of the ocular motor structures within the pons. This combination of clinical findings, termed the 8-1/2 syndrome (cranial nerve 7 + 1-1/2), allows precise localization, and magnetic resonance angiography appears to be the imaging study of choice.
MeSH terms
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Aged
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Anticoagulants / therapeutic use
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Basilar Artery / pathology*
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Cerebrovascular Disorders / complications*
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Cerebrovascular Disorders / diagnosis
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Cerebrovascular Disorders / drug therapy
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Cranial Nerve Diseases / diagnosis
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Cranial Nerve Diseases / drug therapy
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Cranial Nerve Diseases / etiology*
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Diplopia / etiology
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Facial Nerve / pathology*
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Facial Paralysis / diagnosis
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Facial Paralysis / drug therapy
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Facial Paralysis / etiology*
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Giant Cell Arteritis / complications
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Humans
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Magnetic Resonance Angiography
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Male
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Middle Aged
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Nystagmus, Pathologic / etiology
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Ophthalmoplegia / diagnosis
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Ophthalmoplegia / drug therapy
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Ophthalmoplegia / etiology*
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Platelet Aggregation Inhibitors / therapeutic use
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Prednisone / therapeutic use
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Syndrome
Substances
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Anticoagulants
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Platelet Aggregation Inhibitors
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Prednisone