Abstract Details

Title Half-and-Half Syndrome as Manifestation of Acute Ischemic Stroke

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) P8 - Poster Session 8 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-005

Objective Half-and-half syndrome is a rare oculomotor condition when there is impairment of half of the contralateral gaze (due to unilateral internuclear ophthalmoplegia) as well as impairment of half of the ipsilateral gaze (due to injury to the abducens nerve fascicules without damage to the abducens nucleus). There were only three case reports found, two from demyelinating disorders and one from hemorrhage.

Background The patient is a 61 year-old male with history of hepatitis C who presented with sudden-onset dizziness, left hand numbness, diplopia, and unsteadiness with gait.

Design/Methods His neural exam was significant for right eye abduction and adduction palsy, reduced sensation to light touch in the fingers of the left hand and dysmetria of left arm and leg. MRI brain revealed a right posterior parasagittal pontine infarction.

Results

He presented outside of intravenous thrombolysis window. He was treated with antiplatelet. He was found to have elevated LDL and was started on statin. At two months follow-up, his symptoms have completely resolved.

Conclusions We believe this is the first reported case of half-and-half syndrome due to acute ischemic stroke and fourth reported case of any etiology. It is an extreme rare condition and likely underreported. When identified, it localizes well to dorsal pontine.

Authors/Disclosures
George S. Zakhia, MD (Mayo Clinic Health System, Mankato) PRESENTER	Dr. Zakhia has nothing to disclose.
Han Wang, MD (Mayo Clinic Health System Mankato)	Dr. Wang has nothing to disclose.

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