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The "one and a half " syndrome, first reported and named by Miller Fisher in 1967 (1), consists of horizontal gaze palsy to one side along with ipsilateral inter-nuclear ophthalmoplegia (INO) resulting in loss of all horizontal movements in the ipsilateral eye, except abduction of the contralateral eye.
A patient develops horizontal gaze palsy and vertical nystagmus eight weeks after gastric stapling, when the procedure was new.
The net result of this lesion is complete horizontal gaze palsy of ipsilateral eye and preservation of abduction of contralateral eye.

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