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J Neurol Neurosurg Psychiatry 83:834-835 doi:10.1136/jnnp-2011-302144
  • Neurological picture

Vertical ‘half-and-a-half’ syndrome

  1. Naji Riachi
  1. Division of Neurology, University Medical Center Rizk Hospital, Beirut, Lebanon
  1. Correspondence to Dr Rechdi Ahdab, Division of Neurology, University Medical Center Rizk Hospital, Achrafieh, Beirut, Lebanon; chadahdab{at}hotmail.com
  1. Contributors RA performed the clinical evaluation and wrote the first draft. NR reviewed the initial draft and wrote the final draft.

  • Received 29 December 2011
  • Accepted 25 April 2012
  • Published Online First 21 May 2012

Introduction

Strokes in the territory of the thalamo-subthalamic paramedian artery cause unilateral damage to the thalamo-mesencephalic junction. They are associated with several types of vertical gaze disorders because they interrupt the descending fibres that serve vertical gaze.1 These strokes classically result in the vertical ‘one-and-a-half’ syndrome2 that associates bilaterally upward with ipsilateral downward gaze palsy. The contralesional monocular elevation palsy represents another vertical gaze disorder previously described.3 ,4 We report a case of a thalamo-mesencephalic stroke that resulted in a …

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