Gaze palsy and exotropia in internuclear ophthalmoplegia

Johkura, Ken; Kudo, Yoshihisa; Amano, Yu; Kikyo, Hideyuki; Imazeki, Ryoko; Amari, Kazumitsu; Yamamoto, Masahiro

doi:10.1016/j.jns.2015.04.017

Cited by 6 publications

(5 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although a large number within the sample demonstrated an XT on cover testing, not all patients were found to have XT. This is in agreement with the findings of Johkura et al ( 2015 ), who reported that XT, although common in the acute stages of INO, was not present in their entire cohort, and that a number of those initially presenting with XT upon admission showed resolution of XT within one week. Due to the variability between referral to the Orthoptic assessment, it may be that some of the patients had improved since their initial presentation.…”

Section: Discussionsupporting

confidence: 93%

Conservative and Surgical Management of Unilateral and Bilateral Internuclear Ophthalmoplegia (INO)—A Retrospective Analysis

Simmons

Rhodes

2022

British and Irish Orthoptic Journal

View full text Add to dashboard Cite

Aim:To report the outcomes of the natural progression and ophthalmic treatment of patients reviewed in a tertiary hospital trust with unilateral or bilateral internuclear ophthalmoplegia.Method: A retrospective case note analysis was performed and 33 patients diagnosed with unilateral or bilateral internuclear ophthalmoplegia (INO) were identified. The diagnosis, aetiology, presence of diplopia, ophthalmic management options and progression were recorded and analysed. This included both conservative and surgical management. Results:The most common aetiologies of INO within this cohort were stroke/ischaemic (69.7%) and multiple sclerosis (MS) (30.3%). Unilateral INO was more prevalent than bilateral INO, with 20 cases (60.6%) compared to 13 cases (39.4%), respectively. A higher proportion of unilateral INO were attributed to stroke (90%) whilst a higher proportion of bilateral INO were attributed to MS (61.5%). The most prescribed management at primary assessment was occlusion (45.5%) and prisms (24.2%). Some patients required no orthoptic intervention (30.3%). Two patients had surgical management of strabismus secondary to bilateral INO. Conclusion:Occlusion was the most common form of management for symptomatic relief of diplopia. Patients who presented at the first visit with no symptoms were unlikely to need any orthoptic intervention. Of the two patients who went on to require surgical intervention, restoration of binocular single vision (BSV) was achieved postoperatively with the use of a Fresnel prism. However, the differences in both surgical technique and number of surgeries required make this difficult to generalise. Additional research is needed to further explore the surgical management of INO.

show abstract

Section: Discussionsupporting

confidence: 93%

Conservative and Surgical Management of Unilateral and Bilateral Internuclear Ophthalmoplegia (INO)—A Retrospective Analysis

Simmons

Rhodes

2022

British and Irish Orthoptic Journal

View full text Add to dashboard Cite

show abstract

“…Skew deviation is known to occur with strokes of the brainstem or cerebellum [ 8 ]. Exotropia in primary gaze is more typical of bilateral INO; however, it may occur in unilateral INO as was seen in our patient [ 8 , 9 ].…”

Section: Discussionsupporting

confidence: 52%

Internuclear Ophthalmoplegia Secondary to Cocaine Abuse

Rabin

Wasay

Biro

et al. 2017

Case Reports in Ophthalmological Medicine

View full text Add to dashboard Cite

Purpose. To report a case of internuclear ophthalmoplegia (INO) caused by cocaine. Method. We report a case of a 54-year-old female who presented with a left INO three days after snorting cocaine, and we review the literature. Results. MRI of the brain demonstrated several small abnormal foci in the pons on FLAIR and diffusion weighted imaging consistent with ischemic infarction. The patient's symptoms remained stable throughout her hospitalization. She was sent to a rehabilitation facility and was lost to follow-up. Conclusion. In cases of extraocular movement abnormalities, it is important to inquire about recreational drug use.

show abstract

“…Although our patient was orthophoric on presentation, as per previous reports on the acute stage of internuclear ophthalmoplegia (INO), exotropia is not uncommon. [ 3 ] However, it can be frequently overlooked due to short duration. As previously documented, structures vital to vertical and torsional eye movements are rostral interstitial nucleus of the medial longitudinal fasciculus, interstitial nucleus of Cajal, and posterior commissure.…”

Section: Discussionmentioning

confidence: 99%

Metastatic renal cell carcinoma presenting as one-and-a-half syndrome

Patil

Ganger

Sharma

et al. 2017

Indian J Ophthalmol

View full text Add to dashboard Cite

We report a case of 43-year-old male, presented with sudden onset binocular diplopia on lateral gazes. Ocular examination showed features of ipsilateral one-and-a-half syndrome. Comprehensive systemic work in conjunction with magnetic resonance imaging of the brain illustrated irregular mixed solid and cystic lesions in the brainstem, possibly indicative of brain metastases. Further imaging revealed hidden renal cell carcinoma as a primary neoplasm, which led to secondary manifestations.

show abstract

Gaze palsy and exotropia in internuclear ophthalmoplegia

Cited by 6 publications

References 11 publications

Conservative and Surgical Management of Unilateral and Bilateral Internuclear Ophthalmoplegia (INO)—A Retrospective Analysis

Conservative and Surgical Management of Unilateral and Bilateral Internuclear Ophthalmoplegia (INO)—A Retrospective Analysis

Internuclear Ophthalmoplegia Secondary to Cocaine Abuse

Metastatic renal cell carcinoma presenting as one-and-a-half syndrome

Contact Info

Product

Resources

About