Annals of Indian Academy of Neurology
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CLINICAL SIGN
Year : 2018  |  Volume : 21  |  Issue : 4  |  Page : 325-327

Nine syndrome: Case report and review of clinical signs in internuclear ophthalmoplegia


1 Department of Neurology, St. Stephen's Hospital, New Delhi, India
2 Department of Pathology, Medall Healthcare, Ongole, Andhra Pradesh, India
3 Department of Pathology, Guntur Medical College, Andhra Pradesh, India

Correspondence Address:
Dr. Sachin Sureshbabu
Department of Neurology, St. Stephen's Hospital, New Delhi - 110 054
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aian.AIAN_118_18

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The pathologic involvement of brainstem and midbrain nuclei and white matter tracts in various combinations may result in a spectrum of arithmetically derived syndromes. They include ‘one and a half syndrome’, ‘eight and a half syndrome’ and ‘fifteen and a half syndrome’. We report a case of ‘nine syndrome’, which has been reported more recently, caused by caused by acute pontine infarcts and characterised clinically by a combination of internuclear ophthalmolplegia, ipsilateral horizontal gaze palsy, lower motor neuron type of facial palsy, contralateral hemiparesis and hemianesthesia. We highlight the genesis of this combination of clinical signs , revisit the different variants of INO and review the literature on ‘Nine syndrome’.


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