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The one and a half syndrome a unilateral disorder of the pontine tegmentum 20 cases and a review of the literature


, : The one and a half syndrome a unilateral disorder of the pontine tegmentum 20 cases and a review of the literature. Neurology 33(8): 971-980

The "one-and-a-half" syndrome is a clinical disorder of extraocular movements characterized by a conjugate horizontal gaze palsy in 1 direction plus an internuclear ophthalmoplegia in the other. The syndrome is usually due to a single unilateral lesion of the paramedian pontine reticular formation or the abducens nucleus on 1 side, causing the conjugate gaze palsy. It interrupts the internuclear fibers of the ipsilateral medial longitudinal fasciculus after it crosses the midline from its site of origin in the contralateral abducens nucleus (producing failure of adduction of the ipsilateral eye). Twenty cases are reported; 14 had multiple sclerosis.

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