81. One and a half syndrome

  1. The one and a half syndrome is characterized by a conjugate horizontal gaze palsy in one direction and an impairment of the abduction of the eyes in the other. (T/F?)
  2. Horizontal gaze palsy is seen on looking away from the side of the lesion. (T/F?)
  3. The ipsilateral eye has no horizontal movement. (T/F?)
  4. The most common cause of the one-and-a-half syndrome in the young people is Miller-Fisher syndrome. (T/F?)
  5. The most common cause of the one-and-a-half syndrome in older people is multiple sclerosis. (T/F?)
  6. When the lesion that causes a damage to PPRF or abducens nucleus and medial longitudinal fasciculus, also affects the facial nerve, we can talk about an eight-and-a-half syndrome. (T/F?)

  1. F
  2. F
  3. T
  4. F
  5. F
  6. T

73. Descending neural pathways

  1. The posterior funiculus contains two descending tracts: the interfascicular fasciculus and the septomarginal fasciculus. /T/F?)
  2. The lateral corticospinal tract is organized somatotopically,  cervical segments are located laterally and sacral segments medialy.  (T/F?)
  3. The rubrospinal tract is situated in the lateral funiculus of the spinal cord. (T/F?)
  4. The lateral vestibulospinal tract runs the entire length of the spinal cord. (T/F?)
  5. The medial vestibulospinal tract runs down only to the cervical segments of the spinal cord. (T/F?)
  6. Spinospinal tracts are collections of fibers that connect various levels of the spinal cord and they are present in all spinal funiculi (posterior, lateral and anterior). (T/F?)

  1. T
  2. F
  3. T
  4. T
  5. T
  6. T

7. Internuclear ophthalmoplegia:

  1. Results in double vision, due to lesion of the medial longitudinal fasciculus (MLF), which connects the nuclei of oculomotor and abducens nerves. (T/F?)
  2. Is always  unilateral. (T/F?)
  3. Diplopia  is elicited with the gaze to the opposite side of  the affected eye. (T/F?)
  4. Affected eye shows impairment ( slower rate or failure ) of adduction. (T/F?)
  5. Contralateral (not  affected) eye shows vertical nystagmus  with abduction. (T/F?)
  6. If the left eye is affected, the patient will have diplopia when looking to the left. (T/F?)
  7. With rostral MLF lesions, near the oculomotor  nucleus, convergence of  the eyes may be impaired. (T/F?)

  1. T
  2. F
  3. T
  4. T
  5. F
  6. F
  7. T

Henry Vandyke Carter [Public domain], via Wikimedia Commons

  1. Internuclear ophthalmoplegia is also called medial longitudinal fasciculus syndrome  or MLF syndrome.
  2. MLF syndrome can occur unilaterally or bilaterally. Bilateral internuclear ophthalmoplegia is highly suspected for multiple sclerosis, specially with young people.
  1. Contralateral eye characteristically shows horizontal nystagmus with abduction.
  2. If the left eye is affected, the patient will show horizontal diplopia with gaze to the opposite, right side.

Video: https://www.youtube.com/watch?v=MWJz75R01s4