Please use this identifier to cite or link to this item: https://www.um.edu.mt/library/oar/handle/123456789/108138
Title: One-and-a-half syndrome : its presentation, causes and neuroanatomy
Authors: Azzopardi, Matthew
Agius, David
Keywords: Eye -- Movement disorders
Diplopia
Dizziness
Vertigo
Eye -- Muscles -- Anomalies
Issue Date: 2023
Publisher: University of Malta. Medical School
Citation: Azzopardi, M., & Agius, D. (2023). One-and-a-half syndrome : its presentation, causes and neuroanatomy. Malta Medical Journal, 35(1), 124-128.
Abstract: BACKGROUND: One-and-a-half syndrome involves a combination of an ipsilateral horizontal gaze palsy and an ipsilateral internuclear ophthalmoplegia. This condition is easily missed due to its presentation, but can be the first sign of serious disease. We aim to increase awareness of this syndrome’s presentation and give an insight into the intricate neuroanatomical connections that are affected in it.
CASE PRESENTATION: We present a case of a 39-year-old previously healthy female who presented with a one-week history of diplopia and non-vertiginous dizziness. On examination, a left horizontal gaze palsy with deficits in left abduction and right adduction was noted, accompanied by left adduction weakness and right horizontal disconjugate jerk nystagmus in abduction. A diagnosis of OAHS was made, and she was admitted for further tests. An MRI of her brain revealed multiple hyperintensities throughout, along with an enhancing lesion in keeping with active disease. A diagnosis of Multiple Sclerosis was made and she was given a five-day course of methylprednisolone, with which her vision, and ultimately her gait, improved. She was discharged with outpatient follow-up, to further discuss treatment options for her new diagnosis.
CONCLUSION: Diplopia and vertigo are symptoms that should prompt careful clinical examination with proper attention to ocular motility testing, and subsequent referral to neurology if required. Unnecessary delays in diagnosis and management could ultimately be detrimental to the patient, and being aware of uncommon presentations would go a long way in enhancing patient safety.
URI: https://www.um.edu.mt/library/oar/handle/123456789/108138
Appears in Collections:MMJ, Volume 35, Issue 1
MMJ, Volume 35, Issue 1

Files in This Item:
File Description SizeFormat 
MMJ35(1)CR4.pdf416.2 kBAdobe PDFView/Open


Items in OAR@UM are protected by copyright, with all rights reserved, unless otherwise indicated.