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Eight-and-a-half syndrome: a rare presentation.

Vaibhav Ingle¹, Smritimayee Panda², Tejaswini Penuboina¹

¹General Medicine, AIIMS Bhopal, Bhopal, Madhya Pradesh, India.

BMJ Case Reports

|September 4, 2021

Summary

Eight-and-a-half syndrome, a rare neurological condition, involves gaze palsy, internuclear ophthalmoplegia, and facial palsy. This case highlights its occurrence alongside acute ischemic stroke and myocardial infarction.

Keywords:

brain stem / cerebellum ischaemic heart disease stroke

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Area of Science:

Neurology
Ophthalmology
Cardiology

Background:

Eight-and-a-half syndrome is a rare neurological disorder characterized by conjugate horizontal gaze palsy, ipsilateral internuclear ophthalmoplegia, and ipsilateral lower motor neuron facial palsy.
It results from a lesion in the pons affecting the medial longitudinal fasciculus, paramedian pontine reticular formation, and facial nerve fascicle.

Observation:

A 54-year-old male presented with symptoms consistent with right-sided Eight-and-a-half syndrome.
The patient's condition was associated with acute ischemic stroke and ST-elevation myocardial infarction of the inferior wall.

Findings:

The diagnosis of Eight-and-a-half syndrome can be challenging and requires meticulous ocular movement examination.
This case underscores the potential for concurrent cerebrovascular and cardiovascular events presenting as this rare syndrome.

Implications:

Early and accurate diagnosis of Eight-and-a-half syndrome is crucial for timely intervention.
Understanding the association with conditions like ischemic stroke and myocardial infarction can improve patient management and outcomes.