Fisher’s “One and a half syndrome” in myasthenia gravis – a case report
DOI:
https://doi.org/10.67667/NEU.v27i1.226Keywords:
myasthenia gravis, “one and a half“ syndromeAbstract
Fisher’s “One and a half syndrome” is a rare oculomotor lesion characterized by conjugate gaze palsy with contralateral internuclear ophthalmoplegia. The syndrome is due to a unilateral pontine lesion affecting the ipsilateral paramedian pontine reticular formation and/or the abducens nucleus and the adjacent medial longitudinal fasciculus interneurons. It is described in brain stem lesions with different etiology—vascular, demyelinating, neoplastic, inflammatory, and other causes. We present an 81-year-old patient with acutely developed one and a half syndrome, accompanied by unilateral mild ptosis as a debut symptom of myasthenia gravis. The myasthenic symptoms mimic a structural pontine lesion in the patient.
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Copyright (c) 2026 Sylvia Cherninkova, Kristina Kastreva, Yavor Zhelev, Ivailo Tournev
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