Eight and a half syndrome clinically comprises of one-and-a-half syndrome plus ipsilateral facial palsy (Cranial nerve 7 + 1-1/2). Since its initial description by Eggenberger (1) in 1998, only a handful of cases have been reported in literature (2, 3, 4). The presence of this syndrome helps precise localization of the lesion to dorsal pons. The syndrome is most often caused by a stroke (1, 2, 4), however other structural lesions like demyelination and tuberculoma (3) have been implicated.
We report a 55 year old patient with the characteristic syndrome. Magnetic resonance imaging (MRI) of brain confirmed an acute infarction in the dorsal pontine tegmentum. She made a good recovery following intravenous thrombolysis and neuro-rehabilitation. The pathophysiology of the clinical signs and the management of the patient are discussed.

References:
1)Eggenberger E. Eight-and-a-half syndrome: one-and-a-half syndrome plus cranial nerve VII palsy. J Neuro-opthalmol 1998;18:114- 116.
2)Nandhagopal R, Krishnamoorthy SG. Eight-and-a-half syndrome. J Neurol Neurosurg Psychiat 2006;77:463.
3)van Toorn R., Schoeman J.F., Donald P.R. Brainstem tuberculoma presenting as eight-and-a-half syndrome.European Journal of Paediatric Neurology 2006; 10(1): 41-44
4)Sarwal A, Garewal M, Sahota S, Sivaraman M. Eight-and-a-half syndrome. J Neuroimaging. 2009 Jul; 19(3):288-90.

(The patient’s consent for publication of clinical photographs, MRI and video has been obtained.)