Introduction:

the one-and-a-half syndrome, first described by Miller Fisher in 1967, is characterized by the presence of horizontal conjugated gaze palsy and ipsilateral internuclear ophthalmoplegia. Eggenberger discovered the combination of one-and-a-half syndrome and ipsilateral facial nerve palsy, and named it eight-and-a-half syndrome.

Clinical case:

36-year-old patient with a medical history, who comes to the hospital due to a deviation of the mouth and double vision with both eyes looking to the right and left, with dizziness. On ophthalmological examination in the right eye, he presented limited abduction and adduction with preserved vertical movements. Left eye: limitation of adduction of the eye with abduction and preserved vertical movements, nystagmus in abduction and exotropia less than 15 degrees, difficulty in closing the right eye with a deviation of the labial commissure on the left side.

Discussion:

the most frequent causes are pontine infarction and multiple sclerosis, followed by pontine hemorrhages and brain stem tumors. Magnetic resonance imaging was indicated.

Conclusions:

right peripheral facial palsy and one-and-a-half syndrome were diagnosed, the imaging study showed a tumor at the level of the brainstem (bridge). It was treated with radiotherapy.

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