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Eight-and-a-half syndrome: a rare presentation
  1. Vaibhav Ingle1,
  2. Smritimayee Panda1,
  3. Tejaswini Penuboina1 and
  4. Manshi Kashyap2
  1. 1General Medicine, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
  2. 2Neurology, AIIMS Bhopal, Bhopal, Madhya Pradesh, India
  1. Correspondence to Dr Smritimayee Panda; smriti.panda215{at}


Eight-and-a-half syndrome is a rare entity characterised by conjugate horizontal gaze palsy, ipsilateral internuclear ophthalmoplegia and ipsilateral lower motor neuron type facial palsy. It is due to a lesion affecting median longitudinal fasciculus, paramedian pontine reticular formation and facial nerve fascicle on the same side at the level of pons. The diagnosis is easily missed as it needs detailed ocular movement examination. It is mainly caused due to infarction or demyelinating conditions. We are reporting an interesting case of a 54-year-old man with right-side eight-and-a-half syndrome due to acute ischaemic stroke and ST-elevation myocardial infarction of the inferior wall.

  • brain stem / cerebellum
  • stroke
  • ischaemic heart disease

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  • Contributors Supervised by VI. The patient was under the care of VI. The report was written by SP, TP and MK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.