One-and-a-half Syndrome
-A Clinicoradiological Study of 7 cases-

J Korean Neurol Assoc > Volume 6(2); 1988 > Article

Journal of the Korean Neurological Association 1988;6(2): 191-201.

One-and-a-half syndrome 7례에 대한 임상-방사선과적 고찰

이원용, 한설희,하충건,노재규,명호진

서울대학교 신경과.

One-and-a-half Syndrome -A Clinicoradiological Study of 7 cases-

Won-Yong Lee,M.D.,Seol-Heui Han,M.D., Choong-Kun Ha, M.D.,Jae-Kyu Roh,M.D. Ho-Jin Myung, M.D.

Department 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.