DOI: 10.36347/sjmcr.2017.v05i10.002

Pages: 606-609

Eight-and-a-half-syndrome is a rare clinical syndrome characterized impairment of oculomotor movement; a horizontal gaze palsy to one direction, internuclear ophthalmoplegia in the other, and ipsilateral lower motor neuron seventh cranial nerve palsy. We report a case of eight-and-a-half syndrome. A 53-year-old gentleman known to have non-insulin dependent diabetes mellitus, hypertension and hypercholesterolaemia presented with double vision and dizziness of 1-week duration. There were not associated with reduced vision, no symptoms of raised intracranial pressure, not associated with limb weakness and abnormal speech. At presentation, patient had elevated blood pressure and poorly controlled blood sugar. There were right eye limitation in adduction with contralateral abducting nystagmus, right eye limited abduction consistent with right one and a half syndrome. There was also right lower motor neuron 7th nerve palsy. Eight-and-a-half syndrome is a combination of ipsilateral one-and-a half syndrome and lower motor neuron 7th nerve palsy. Brainstem conjugate gaze palsy is an important clinical diagnosis, aid in diagnosis in even a small pontine lesion.