Posterior Internuclear Ophthalmoplegia

Rothstein, Ted L.

doi:10.1001/archneur.1971.00480330019001

Cited by 13 publications

(10 citation statements)

References 34 publications

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“…Several authors ascribed supranuclear cranial palsies to the small lesions in the medial lemniscus [25, 26, 27, 28, 29]. In their reports the lesions involving the APT were presumed to be responsible for the supranuclear cranial palsies.…”

Section: Discussionmentioning

confidence: 99%

Aberrant Pyramidal Tract in the Medial Lemniscus of the Human Brainstem:Normal Distribution and PathologicalChanges

Yamashita¹,

Yamamoto²

2001

Eur Neurol

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We examined the consistency of the so-called aberrant pyramidal tract (APT) in 150 consecutive autopsied human brains using the modified Bielschowsky stain for axons. We were able to identify the APT in all brains except for one with holoprosencephaly. The APT left the pyramidal tract within the crus cerebri and passed in the medial lemniscus of the pons through the upper medulla oblongata. In 13 of the 63 brains with cerebrovascular diseases, wallerian degeneration was found in the APT on the ipsilateral side of the cerebral lesions. Further, the APT showed depletion of small-sized fibers in 2 of the 5 brains with multiple-system atrophy. These findings confirmed that the APT is a normal descending fiber tract and a part of the pyramidal tract.

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Section: Discussionmentioning

confidence: 99%

Aberrant Pyramidal Tract in the Medial Lemniscus of the Human Brainstem:Normal Distribution and PathologicalChanges

Yamashita¹,

Yamamoto²

2001

Eur Neurol

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“…In none of the previously reported cases, in which a prenuclear origin of pINO was suggested, a definite supranuclear lesion site and fully preserved oculocephalic responses were found [2,5,6,9]. In cases of pINO without morphological substrate the lesions were thought to be too small to be detected [6,9].…”

mentioning

confidence: 88%

“…In cases of pINO without morphological substrate the lesions were thought to be too small to be detected [6,9]. To our knowledge there is only one clinicopathological study of pINO in the literature, but the anatomical assumptions of this study are not compatible with current concepts of ocular motor control [2]. Topographically, some authors have localized the presumed lesion between the paramedian pontine reticular formation (PPRF) and the ipsilateral abducens nucleus [5,6], but experimental animal studies reveal the horizontal gaze fibers related to abduction never to be separated from those for adduction [10].…”

mentioning

confidence: 92%

“…In contrast to internuclear ophthalmoplegia (INO), the pathophysiological concept of pINO has been debated since it was first proposed by Lutz [1] as a lesion of a supranuclear pathway of abduction. Except for a clinicopathological study by Rothstein and Alvord [2], in which a lesion of "aberrant pyramidal tract" fibers to the abducens nucleus was postulated, there has been no pathological material to support the concept of pINO as a supranuclear entity. We report a clinicopathological study of unilateral so-called pINO secondary to a pontine glioma.…”

mentioning

confidence: 99%

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So-called posterior internuclear ophthalmoplegia due to a pontine glioma: a clinicopathological study

Wiest

Wanschitz

Baumgärtner

et al. 1999

Journal of Neurology

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Sirs: So-called posterior internuclear ophthalmoplegia (pINO) is referred to as a putative supranuclear disorder of horizontal gaze, characterized by unilateral abduction paresis and dissociated adduction nystagmus in the contralateral eye. In contrast to internuclear ophthalmoplegia (INO), the pathophysiological concept of pINO has been debated since it was first proposed by Lutz [1] as a lesion of a supranuclear pathway of abduction. Except for a clinicopathological study by Rothstein and Alvord [2], in which a lesion of "aberrant pyramidal tract" fibers to the abducens nucleus was postulated, there has been no pathological material to support the concept of pINO as a supranuclear entity. We report a clinicopathological study of unilateral so-called pINO secondary to a pontine glioma. The clinical findings, electro-oculography, and pathological study suggested a unilateral lesion of the abducens fasciculus, mimicking features of a supranuclear oculomotor disturbance.A 59-year-old man was admitted to our hospital with complaints of dysarthria and ataxia for 2 weeks. Three months previously he had developed intermittent horizontal diplopia on right gaze. Ophthalmological and neurological results at that time were normal. In the following weeks he noticed progressive bilateral trigeminal sensory loss and dysphagia. His medical history was unremarkable except for chronic polyarthritis. On admission the patient had broad-based gait, dysphagia, and dysarthria. Pupils were equal and reactive, and the corneal reflex was decreased on the left. Convergence was full with a normal near response of the pupils. The gag reflex was absent, and there was paresis of the soft palate on the left. An incomplete peripheral facial palsy was evident on the right, and sensory functions below the face were normal. Limb strength was normal, and slight dysdiadochokinesia was present in the right arm. Reflexes were brisk, and Babinski signs were present bilaterally.

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“…Dieses unmittelbar ventral der Augenmuskelkerne liegende Bündel erhält Fasern aus dem Nucleus interstitialis (Cajal), dem Nucleus vestibularis lateralis (Deiters), den Nuclei ventralis et dorsalis des Corpus trapezius und Kollateralen fast aller sensibler Hirnnerven. Die Koordination dieser verschiedenen Kerne untereinander ermöglicht: konjugierte Bewegungen der Bulbi, Einstellbewegungen bei veränderter Kopfhaltung sowie bei Reizungen des Gleichgewichtssystems und Augenbewegungen nach Schalleindrücken oder sensiblen Reizen.Unterbrechungen des medialen Längsbün-dels zwischen den Kernen des dritten und sechsten Hirnnerven führen zu dem Bild der vorderen oder hinteren internucleären Ophthalmoplegie(5,6,8,12,14). Bei der vorderen internucleären Ophthalmoplegie (i.…”

unclassified

Tumoren der Pinealisregion: Teil I: Neurologische und neuroradiologische Symptomatik bei 23 Patienten

Hase¹,

H²,

Schindler³

1979

Minim Invasive Neurosurg

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After a short anatomical review about the neighbourhood of the lamina quadrigemina 23 patients with different processes in the pineal region were investigated with regard to their neurological symptoms and radiological findings. Symptoms of the eyes in conjunction with signs of elevated intracranial pressure in most of the cases show the way to the diagnosis which will be completed by ventriculography, angiography, and recently by computer tomography with regard to the expansion of the process; any prediction about the kind of tumour is possible only in a little percentage.

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Posterior Internuclear Ophthalmoplegia

Cited by 13 publications

References 34 publications

Aberrant Pyramidal Tract in the Medial Lemniscus of the Human Brainstem:Normal Distribution and PathologicalChanges

Aberrant Pyramidal Tract in the Medial Lemniscus of the Human Brainstem:Normal Distribution and PathologicalChanges

So-called posterior internuclear ophthalmoplegia due to a pontine glioma: a clinicopathological study

Tumoren der Pinealisregion: Teil I: Neurologische und neuroradiologische Symptomatik bei 23 Patienten

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