0
December 1989, Vol 46, No. 12 >
Article | December 1989

Vertical One-and-a-Half Syndrome: Title and subTitle BreakSupranuclear Downgaze Paralysis With Monocular Elevation Palsy

Dirk Deleu, MD; Therese Buisseret, MD; Guy Ebinger, MD
[+] Author Affiliations

Accepted for publication February 15, 1989.

Reprint requests to Department of Neurology, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium (Dr Deleu).


Arch Neurol. 1989;46(12):1361-1363. doi:10.1001/archneur.1989.00520480105028
Text Size: A A A
Published online
Article
References
Comments

• A patient with bilateral infarction in the mesodiencephalic region showed impairment of all downward rapid eye movements (including vestibulo-ocular movements) and foveal smooth pursuit (nondissociated downgaze paralysis) associated with monocular paralysis of elevation (vertical one-and-a-half syndrome). Bell's phenomenon and all types of horizontal eye movements were preserved. The lesions may have affected the efferent tracts of the rostral interstitial nucleus of the medial longitudinal fasciculus bilaterally and the premotor fibers to the contralateral superior rectus subnucleus and ipsilateral inferior oblique subnucleus, either before or after decussation in the posterior commissure.

REFERENCES

1 +
Bender MB.  Brain control of conjugate horizontal and vertical eye movements: a survey of the structural and functional correlates . Brain . 1980;;103:23-69.
2 +
Christoff N.  A clinicopathologic study of vertical eye movements . Arch Neurol . 1974;;31:1-8.
3 +
Pierrot-Deseilligny C, Chain F, Gray F, Serdaru M, Escourolle R, Lhermitte F.  Parinaud's syndrome: electro-oculographic and anatomical analyses of six vascular cases with deductions about vertical gaze organization in the premotor structures . Brain . 1982;;105:667-696.
4 +
Büttner-Ennever JA, Büttner U, Cohen B, Baumgartner G.  Vertical gaze paralysis and the rostral interstitial nucleus of the medial longitudinal fasciculus . Brain . 1982;;105:125-149.
5 +
Baloh RW, Furman JM, Yee RD.  Dorsal midbrain syndrome: clinical and oculographic findings . Neurology . 1985;;35:549-562.
6 +
Deleu D, Solheid C, Michotte A, Ebinger G:  Dissociated ipsilateral horizontal gaze palsy in one-and-a-half syndrome: a clinicopathologic study . Neurology . 1988;;38:1278-1280.
7 +
Henn V, Lang W, Hepp K, Reisine H.  Experimental gaze palsies in monkeys and their relation to human pathology . Brain . 1984;;107:619-636.
8 +
Trojanowski JQ, Lafontaine MH.  Neuroanatomical correlates of selective downgaze paralysis . J Neurol Sci . 1981;;52:91-101.
9 +
Jacobs L, Anderson PJ, Bender MB.  The lesions producing paralysis of downward but not upward gaze . Arch Neurol . 1973;;28:319-323.
10 +
Halmagyi GM, Evans WA, Hallinan JM.  Failure of downward gaze: the site and nature of the lesion . Arch Neurol . 1978;;35:22-26.
11 +
Anderson JH.  Ocular torsion in the cat after lesions of the interstitial nucleus of Cajal . Ann NY Acad Sci . 1986;;374:865-871.
12 +
Ranalli PJ, Sharpe JA, Fletcher WA.  Palsy of upward and downward saccadic, pursuit, and vestibular movements with a unilateral midbrain lesion: pathophysiologic correlations . Neurology . 1988;;38:114-122.
13 +
Lessell S.  Supranuclear paralysis of monocular elevation . Neurology . 1975;;25:1134-1136.
14 +
Metz HS.  Double elevator palsy . Arch Ophthalmol . 1979;;97:901-903.
15 +
Ford CS, Schwartze GM, Weaver RG, Troost BT.  Monocular elevation paresis caused by an ipsilateral lesion . Neurology . 1984;;34:1264-1267.
16 +
Jampell RS, Fells P.  Monocular elevation paresis caused by a central nervous system lesion . Arch Ophthalmol . 1968;;80:45-57.
17 +
Malbran E, Norbis AL.  Unilateral paralysis of the elevators of supranuclear origin . Br J Ophthalmol . 1955;;39:73-84.
18 +
Kirkham TH, Kline LB.  Monocular elevator paresis, Argyll Robertson pupils and sarcoidosis . Can J Ophthalmol . 1976;;11:330-335.
19 +
Man HMX.  A propos d'un cas de paralysie supranucléaire unilaterale des muscles élévateurs . Bull Soc Ophtalmol Fr . 1967;;67:400-405.
20 +
Shanzer S, Goto K, Cohen B, Bender MB.  Median longitudinal fasciculus and vertical eye movements . Trans Am Neurol Assoc . 1964;;89:255-256.
21 +
Bogousslavsky J, Regli F.  Upgaze palsy and monocular paresis of downward gaze from ipsilateral thalamo-mesencephalic infarction: a vertical 'one-and-a-half' syndrome . J Neurol . 1984;;231:43-45.
22 +
Mehler MF:  The neuro-ophthalmologic spectrum of the rostral basilar artery syndrome . Arch Neurol . 1988;;45:966-971.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Bender MB.  Brain control of conjugate horizontal and vertical eye movements: a survey of the structural and functional correlates . Brain . 1980;;103:23-69.
2 +
Christoff N.  A clinicopathologic study of vertical eye movements . Arch Neurol . 1974;;31:1-8.
3 +
Pierrot-Deseilligny C, Chain F, Gray F, Serdaru M, Escourolle R, Lhermitte F.  Parinaud's syndrome: electro-oculographic and anatomical analyses of six vascular cases with deductions about vertical gaze organization in the premotor structures . Brain . 1982;;105:667-696.
4 +
Büttner-Ennever JA, Büttner U, Cohen B, Baumgartner G.  Vertical gaze paralysis and the rostral interstitial nucleus of the medial longitudinal fasciculus . Brain . 1982;;105:125-149.
5 +
Baloh RW, Furman JM, Yee RD.  Dorsal midbrain syndrome: clinical and oculographic findings . Neurology . 1985;;35:549-562.
6 +
Deleu D, Solheid C, Michotte A, Ebinger G:  Dissociated ipsilateral horizontal gaze palsy in one-and-a-half syndrome: a clinicopathologic study . Neurology . 1988;;38:1278-1280.
7 +
Henn V, Lang W, Hepp K, Reisine H.  Experimental gaze palsies in monkeys and their relation to human pathology . Brain . 1984;;107:619-636.
8 +
Trojanowski JQ, Lafontaine MH.  Neuroanatomical correlates of selective downgaze paralysis . J Neurol Sci . 1981;;52:91-101.
9 +
Jacobs L, Anderson PJ, Bender MB.  The lesions producing paralysis of downward but not upward gaze . Arch Neurol . 1973;;28:319-323.
10 +
Halmagyi GM, Evans WA, Hallinan JM.  Failure of downward gaze: the site and nature of the lesion . Arch Neurol . 1978;;35:22-26.
11 +
Anderson JH.  Ocular torsion in the cat after lesions of the interstitial nucleus of Cajal . Ann NY Acad Sci . 1986;;374:865-871.
12 +
Ranalli PJ, Sharpe JA, Fletcher WA.  Palsy of upward and downward saccadic, pursuit, and vestibular movements with a unilateral midbrain lesion: pathophysiologic correlations . Neurology . 1988;;38:114-122.
13 +
Lessell S.  Supranuclear paralysis of monocular elevation . Neurology . 1975;;25:1134-1136.
14 +
Metz HS.  Double elevator palsy . Arch Ophthalmol . 1979;;97:901-903.
15 +
Ford CS, Schwartze GM, Weaver RG, Troost BT.  Monocular elevation paresis caused by an ipsilateral lesion . Neurology . 1984;;34:1264-1267.
16 +
Jampell RS, Fells P.  Monocular elevation paresis caused by a central nervous system lesion . Arch Ophthalmol . 1968;;80:45-57.
17 +
Malbran E, Norbis AL.  Unilateral paralysis of the elevators of supranuclear origin . Br J Ophthalmol . 1955;;39:73-84.
18 +
Kirkham TH, Kline LB.  Monocular elevator paresis, Argyll Robertson pupils and sarcoidosis . Can J Ophthalmol . 1976;;11:330-335.
19 +
Man HMX.  A propos d'un cas de paralysie supranucléaire unilaterale des muscles élévateurs . Bull Soc Ophtalmol Fr . 1967;;67:400-405.
20 +
Shanzer S, Goto K, Cohen B, Bender MB.  Median longitudinal fasciculus and vertical eye movements . Trans Am Neurol Assoc . 1964;;89:255-256.
21 +
Bogousslavsky J, Regli F.  Upgaze palsy and monocular paresis of downward gaze from ipsilateral thalamo-mesencephalic infarction: a vertical 'one-and-a-half' syndrome . J Neurol . 1984;;231:43-45.
22 +
Mehler MF:  The neuro-ophthalmologic spectrum of the rostral basilar artery syndrome . Arch Neurol . 1988;;45:966-971.

Correspondence

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems