Thursday January 18th 2018

One-and-a-Half Syndrome: An Unusual Cause of Dizziness

This is a rare cause of dizziness, which can be seen in younger patients with multiple sclerosis. Uncommon in the elderly, it is usually a result of a brainstem infarct. An 80 year old CCRC resident developed the sudden onset of imbalance. When she tried to turn her eyes she developed double vision, associated with nausea and gait dysfunction. She felt extremely dizzy, especially when she turned her eyes. Neurologic exam was remarkable for complete paralysis of horizontal gaze in the right eye and preserved abduction of the left eye. Brain imaging was initially read as negative; however, after review was felt to support a subacute punctate pontine infarct potentially involving the region of the right medial longitudinal fasciculus and/or the right VI nerve nucleus region. Aspirin therapy …

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One-and-a-Half Syndrome: An Unusual Cause of Dizziness

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