Dr.SANDHYA DHARWADKAR, H13485
Background: Eight-and-a-half syndrome is caused by a lesion in the dorsal tegmentum of the caudal pons involving parapontine reticular formation(PPRF) and the median longitudinal fasciculus(MLF), as well as the nucleus / fasiculus of facial nerve. It is characterized by horizontal gaze palsy with internuclear ophthalmoplegia , and ipsilateral LMN 7th nerve palsy.
Case outline : A 46 year old male known to have type II diabetes mellitus, hypertension and hypercholesterolaemia presented with 2-day history of diplopia ,deviation of mouth to right .Right eye-limitation in adduction with abducting nystagmus, left eye-limited abduction and adduction & left LMN 7th nerve palsy with both eyes PDR changes in fundus. Brain CT scan revealed multiple infarcts located in the left paramedian aspect of the dorsal pons.
Conclusions: Recognition of the spectrum of eight and a half syndrome allows precise anatomic localization of the lesion to pontine tegmentum region.
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