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Seven-and-a-half syndrome
  1. Zhihong Xu1,
  2. Yuying Zhao1,
  3. Chuanzhu Yan1,2,3,
  4. Kunqian Ji1
  1. 1Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Shandong University, Jinan, Shandong, China
  2. 2Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao),Shandong University, Qingdao, Shandong, China
  3. 3Brain Science Research Institute, Shandong University, Jinan, Shandong, China
  1. Correspondence to Professor Kunqian Ji, Qilu Hospital of Shandong University, Jinan, China; jikunqian{at}

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A 60-year-old man had a 4-day history of sudden onset dizziness and blurred vision. On examination, there was limited right eye adduction, horizontal abducting nystagmus in the left eye and pronounced right-sided peripheral facial palsy (see figure 1 and online supplemental video). MRI of brain showed an acute lacunar infarction in the dorsal tegmentum of the pons (figure 1). An MR angiogram indicated stenosis of the right posterior cerebral artery. We prescribed aspirin and clopidogrel and he partially recovered over several weeks.

Supplementary video


Figure 1

(Left) MR scan of brain showing a small lesion (yellow arrow) in the dorsal tegmentum of the pons with diffusion restriction and long T1 long T2 signals suggesting acute infarction. (Right) Clinical picture (video still) showing right exotropia with limited adduction. …

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  • Contributors ZX drafted the manuscript, obtained medical history and materials; KJ designed and conceptualised study; CY and YZ revised the manuscript for intellectual content.

  • Funding This work was supported by the National Key R&D Programme of China (No.2021YFC2700904), National Natural Science Foundation of China (No.82171394), Qingdao Technology Programme for Health and Welfare (22-8-7-smjk-1-nsh) and the Taishan Scholars Programme of Shandong Province, General Project on Educational and Teaching Reform Research of Shandong University(2023Y026), Undergraduate Education Teaching Research and Reform Project of Cheeloo College of Medicine of Shandong University(qlyxjy-202319).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed by Tom Hughes, Cardiff, UK.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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