摘要
1又1/2症候群，為一眼共軛水平型凝視麻痺，合併另眼核間眼肌麻痺，原則上可以分成3型。在因腦幹梗塞所致之核間眼肌麻痺患者中，有20%會以本症候群為表徵。一55歲男性因突發複視急診於本院，兩眼均可向上或向下轉動，右眼可以部份內收，卻呈現外斜視，左眼則完全無法內收或外展，呈現輕度上斜視。磁振造影顯示靠近第4腦室、左側正中旁橋腦被蓋有一急性梗塞病灶，臨床診斷為橋腦梗塞併發1 又1/2症候群。依照美國國家衛生研究院中風評量表評估為1分，給予點滴輸液及每天100毫克之aspirin治療。1個月後，右眼外斜視消失，兩眼均可外展，但左眼依然無法內收，呈現輕度上斜視。未來仍需長期追蹤，不僅確認其預後，更要排除是否仍有其他腦部遲發性病變。
並列摘要
One-and-a-half syndrome (OHS) is characterized by a combination of unilateral horizontal gaze paralysis together with internuclear ophthalmoplegia (INO) and has three types. Among those cases with brainstem infarction causing INO, 20% present with OHS. A 55-year-old man presented with sudden diplopia at our emergency room. Both eyeballs could upward or downward gaze. The right eyeball could partially adduct, but showed exotropia; however, the left eyeball showed hypertropia, and could not adduct or abduct. Brain magnetic resonance imaging demonstrated an acute left paramedian pontine infarction near the 4th ventricle. Therefore, he was diagnosed with pontine infarction with OHS. The patient's National Institutes of Health Stroke Scale was one, so intravenous fluid supportive treatment and anti-platelet therapy, 100 mg aspirin daily, was recommended. One month later, the right exotropia had subsided. Both eyeballs could abduct. However, the left eyeball still showed hypertropia, and could not adduct. The patient's prognosis will be followed up in the future because another delayed-type brain lesion needs to be excluded.
延伸閱讀
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