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2020, Number 5

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Revista Habanera de Ciencias Médicas 2020; 19 (5)

Eight-and-a-half syndrome secondary to lupus vasculopathy. A case presentation

Morales CE, Vargas AGA, Bustamante SA

Language: Spanish
References: 14
Page: 1-10
PDF size: 932.92 Kb.


ABSTRACT

Introduction: The diagnostic and therapeutic management of patients with systemic lupus erythematosus who develop a neuropsychiatric involvement represents one of the biggest challenges due to the heterogeneity of the ways in which it can occur and the absence of diagnostic criteria.
Objective: To recognize the clinical forms of presentation of neurophthalmological syndromes that express pontine involvement.
Case presentation: Seventy-one-year-old man with history of systemic lupus erythematosus with neuropsychiatric involvement who acutely develops an emetic episode in the course of a hypertensive emergency followed by a paralysis of the horizontal gaze to the left, a right-sided posterior internuclear ophthalmoplegia and a left facial palsy. In the neuroimaging, a multifocal involvement with marked pontine damage is observed.
Conclusions: Recognizing the clinical forms of presentation of these rare neurophthalmological disorders that generally occur in an acute or subacute form allows the neurologist to perform the topographic diagnosis of the lesion at a protuberancial level with high precision from the time when the patient attends the Emergency Department and reduces the possible differential diagnoses to a vascular, demyelinating or occupational etiology of space.


REFERENCES

  1. Chessa E, Piga M, Floris A, Mathieu A, Cauli A. Demyelinating syndrome in SLE: review of different disease subtypes and report of a case series. Reumatismo. 2017; 69 (4): 175-83.

  2. Díaz Cortés D, Correa González N, Díaz MC, Martín Gutiérrez J, Fernández Ávila D. Compromiso del sistema nervioso central en el lupus eritematoso sistémico. Rev Colomb Reumatol. 2015;22(1):16-30.

  3. Montiel Jarolin D, Paredes N, Oviedo R. Manifestaciones Neurológicas en el Lupus Eritematoso Sistémico. Caso clínico. Paraguay. Rev Nac (Itauguá) [Internet]. 2010 [Citado 02/07/2016];2(2):45-50. Disponible en: Disponible en: http://scielo.iics.una.py/scielo.php?script=sci_arttext&pid=S2072-81742010000200009&lng=en

  4. Xue F, Zhang L, Zhang L, Ying Z, Sha O, Ding Y. One-and-a-half syndrome with its spectrum disorders. Quant Imaging Med Surg [Internet]. 2017 [Citado 02/07/2016];7(6):691-7. Disponible en: Disponible en: http://doi.org/10.21037/qims.2017.12.04

  5. Mesina BV, Sosuan GM, Reyes KB. Eight-and-a-half syndrome: a rare potentially life-threatening disease. GMS Ophthalmol Cases [Internet]. 2018 [Citado 02/07/2016];8:[Aprox. 2 p.]. Disponible en: Disponible en: http://doi.org/10.3205/oc000086

  6. Kirkpatrick C. Eight-and-a-Half Syndrome. In: EyeRounds.org [Internet]. Estados Unidos: University of Iowa Department of Ophthalmology and Visual Sciences; 2015 [Citado 02/07/2016]. Disponible en: Disponible en: https://www.webeye.ophth.uiowa.edu/eyeforum/atlas/pages/eightand-a-half-syndrome/index.htm

  7. Mahale RR, Mehta A, John AA, Javali M, Abbas MM, Rangasetty S. "Nine" syndrome: A new neuroophthalmologic syndrome: Report of two cases. Ann Indian Acad Neurol [Internet]. 2015 [Citado 18/10/2019];18:335-7. Disponible en: Disponible en: http://www.annalsofian.org/text.asp?2015/18/3/335/157180

  8. Skaat A, Huna Baron R. Eight-and-a-half syndrome: a rare pontine neuro-ophthalmologic syndrome. Arch Neurol [Internet]. 2012 Jul [Citado 18/10/2019];69(7):934-5. Disponible en: Disponible en: http://doi.org/10.1001/archneurol.2011.2185

  9. Sampath Kumar NS, Raju CG, Kiran PR, Kumar TA, Gopal BV, Khaseem DB. Eight-and-a-half syndrome: a rare presentation of pontine infarction. J Stroke Cerebrovasc Dis [Internet]. 2014 Sep [Citado 18/10/2019];23(8):e389-e391. Disponible en: Disponible en: http://doi.org/10.1016/j.jstrokecerebrovasdis.2014.01.002

  10. Mortzos P, Nordling MM, Sørensen TL. Eight-and-a-half syndrome as presenting sign of childhood multiple sclerosis. J AAPOS [Internet]. 2014 Oct [Citado 18/10/2019];18(5):490-2. Disponible en: Disponible en: http://doi.org/10.1016/j.jaapos.2014.05.007

  11. Van Toorn R, Schoeman JF, Donald PR. Brainstem tuberculoma presenting as eight-and-a-half syndrome. Eur J Paediatr Neurol [Internet]. 2006 Jan [Citado 18/10/2019];10(1):41-4. Disponible en: Disponible en: http://doi.org/10.1016/j.ejpn.2005.11.003

  12. Duffy A, Yi PS, Verro P. Eight-and-a-half syndrome. Neurol Clin Pract [Internet]. 2014 [Citado 18/10/2019];4:526-7. Disponible en: Disponible en: http://doi.org/10.1212/CPJ.0000000000000088

  13. Bocos Portillo J, Ruiz Ojeda J, Gómez Beldarraín M, Vázquez Picon R, García Monco JC. Eight-and-a-Half Syndrome. JAMA Neurol [Internet]. 2015 Jul [Citado 18/10/2019];72(7):830. Disponible en: Disponible en: http://doi.org/10.1001/jamaneurol.2015.0255

  14. Rosini F, Pretegiani E, Guideri F. Eight and a half syndrome with hemiparesis and hemihypesthesia: The nine syndrome?. Journal of Stroke and Cerebrovascular Diseases. 2013; 22(8):e637-e638.




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