Sixteen-and-a-half syndrome with metastatic pons tumor A case reportopen access
- Authors
- Choi, Shin-Myeong; Kim, Tae Gi; Chung, Junkyu; Joo, Jin-Ho; Park, In-Ki; Moon, Sang Woong; Shin, Jae-Ho
- Issue Date
- Nov-2019
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- nonsmall cell lung cancer; ophthalmoplegia; 16-and-a-half syndrome
- Citation
- MEDICINE, v.98, no.47
- Journal Title
- MEDICINE
- Volume
- 98
- Number
- 47
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74683
- DOI
- 10.1097/MD.0000000000018006
- ISSN
- 0025-7974
1536-5964
- Abstract
- Rationale: One-and-a-half syndrome (OAAH) is characterized as the combination of ipsilateral horizontal gaze palsy and internuclear ophthalmoplegia. OAAH syndrome accompanied with 7th and 8th cranial nerve palsy is called 16-and-a-half syndrome. We aimed to report the case of 16-and-a-half syndrome with metastatic pons tumor. Patient concerns: A 57-year-old male diagnosed with nonsmall-cell lung cancer (NSCLC) with brain metastasis occurring 15 months ago was referred to our clinic with the chief complaint of horizontal diplopia and right gaze palsy. Diagnosis: According to the patient symptom, ocular examination, and radiographic findings, he was diagnosed as 16-and-a-half syndrome which was caused by brain tumor metastasis from NSCLC. Interventions: We referred him to hemato-oncology department and he was treated with radiation and supportive therapy. Outcomes: Unfortunately, the patient passed away 1 month later without improvement of ophthalmoplegia. Lessons: The clinical findings of our case indicate 16-and-a-half syndrome caused by brain tumor metastasis from NSCLC, which to our knowledge has not been previously reported. The case highlights a rare cause of OAAH spectrum disease and the importance of a systemic work-up including associated neurologic symptoms and brain imaging in patients with horizontal gaze palsy.
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