What Time Is It? It Is 8 and 1/2 Time: A Rare Case of Ischemic Stroke Consistent With Eight-and-a-Half Syndrome

Authors

Jessica Daza, The University of Texas Rio Grande ValleyFollow
Marcelo Bedoya-Sommerkamp, University of Texas Health Science Center at Houston
Eunbee Cho, The University of Texas Rio Grande ValleyFollow
Celia Patricia Daza, Universidad Libre de ColombiaFollow
Francisco Gomez, The University of Texas Rio Grande Valley
Fatimah Bello, The University of Texas Rio Grande ValleyFollow
Jia Lin, University of Texas Health Science Center at Houston

Document Type

Article

Publication Date

10-2025

Abstract

Eight-and-a-half syndrome is a rare neuro-ophthalmic syndrome characterized by conjugate horizontal gaze palsy, ipsilateral internuclear ophthalmoplegia, and ipsilateral facial nerve palsy. It results from a lesion affecting the paramedian pontine reticular formation, the medial longitudinal fasciculus, and the abducens nucleus of the same side, at the level of the lower pons. We present a case of a 49-year-old man with 2-week diplopia and 3-day right-sided facial droop, drooling, and dysarthria. CT angiography of the head and neck revealed atherosclerotic disease, with decreased caliber of the basilar artery at the level of the pons. Brain MRI showed a subacute ischemic lesion in the right dorsal pons. The prognosis is favorable with improvement of facial palsy and ocular symptoms. In addition to treating the underlying etiology, neurorehabilitation is indicated. This case highlights the importance of identifying the level of the lesion in patients with gaze palsy and facial droop, as well as correlating the findings into syndromic diagnoses.

Comments

© 2025 American Federation for Medical Research. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages

Recommended Citation

Daza, J., Bedoya-Sommerkamp, M., Cho, E., Daza, C., Gomez, F., Bello, F., & Lin, J. (2025). What Time Is It? It Is 8 and 1/2 Time: A Rare Case of Ischemic Stroke Consistent With Eight-and-a-Half Syndrome. Journal of Investigative Medicine High Impact Case Reports, 13, 23247096251363013. https://doi.org/10.1177/232470962513630

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Publication Title

Journal of Investigative Medicine High Impact Case Reports

DOI

10.1177/232470962513630

Academic Level

faculty

Mentor/PI Department

Internal Medicine