internuclear ophthalmoplegia
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2021 ◽  
Jun Wang ◽  
Chuan Yu ◽  
Yiyun Jiang ◽  
Xiang Li ◽  
Yiyi Fang

Abstract Background: Wall-eyed bilateral internuclear ophthalmoplegia syndrome (WEBINO) is a rare disorder comprising bilateral exotropia, bilateral internuclear ophthalmoplegia, and impaired convergence. It is usually caused by a midbrain lesion. Case presentation :We describe a rare case of WEBINO, with the lesion located in the lower pons, in a 69-year-old man with acute ischemic stroke. Conclusions :Our report alerts physicians to the possibility of bilateral WEBINO due to unilateral infarction.

2021 ◽  
Vol 8 (11) ◽  
pp. 1752
Mary Stephen A. ◽  
Jayasri P. ◽  
Harigaravelu P. J.

Internuclear ophthalmoplegia is characterised by restricted ocular motility in lateral gaze in which the affected eye shows impairment of adduction and it results from damage to medial longitudinal fasciculus (MLF). Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) is an extremely rare neurological manifestation which has typical signs including primary gaze exotropia, vertical gaze palsy, ptosis, abducting nystagmus. The common and serious etiological factor is cerebrovascular accident involving the vessels supplying MLF and many cases have life threatening associated neurological impairment. In this case report we have discussed about a gentleman who presented with bilateral ptosis, primary gaze exotropia and headache. Patient found to have vertical gaze palsy and abducting nystagmus on examination. Computed tomography (CT) imaging shows infarct in pontine region and CT angiography revealed basilar artery occlusion supplying region of pons with involvement of posterior cerebral artery. Patient treated with antiplatelet and diplopia managed. Patient showed improvement on subsequent follow-up visits.

2021 ◽  
Vol 429 ◽  
pp. 118466
Lina Carazo Barrios ◽  
Minerva Mañez Sierra ◽  
Olmo Leon Plaza ◽  
Carlos De La Cruz Cosme

2021 ◽  
Vol Publish Ahead of Print ◽  
Cina Karimaghaei ◽  
Subahari Raviskanthan ◽  
Zane D. Foster ◽  
Peter W. Mortensen ◽  
Andrew G. Lee

2021 ◽  
Vol Publish Ahead of Print ◽  
Murtaza M. Mandviwala ◽  
James W. Verbsky ◽  
Alexander J. Khammar ◽  
Ryan D. Walsh

2021 ◽  
Vol 14 (9) ◽  
pp. e244830
Shruti Sinha ◽  
Bhaimangesh Bhanudas Naik ◽  
Jaishree Ghanekar

A 48-year-old woman presented with sudden-onset altered sensorium 2 days after a snake bite (unidentified species) and was found to have a large right frontal intracerebral haemorrhage (ICH) with transtentorial herniation (TTH) causing brain stem compression. A day later, neurological examination revealed internuclear ophthalmoplegia (INO) fitting the clinical description of wall eyed bilateral INO syndrome. INO is a rare ocular motor sign, the most common causes being brain stem infarction, haemorrhage or demyelinating disease. It rarely acts as a false localising sign, such as in this case, and in an even rarer cause for ICH, that is, haemotoxic snake bite without initial evidence of coagulopathy. An emphasis needs to be laid on detailed physical examination, often considered a lost art nowadays, to help detect subtle clinical signs which could herald ominous complications of conditions like TTH and help in early diagnosis and treatment of the same.

2021 ◽  
Vol Publish Ahead of Print ◽  
Young-Bin Park ◽  
Seol-Hee Baek ◽  
Sun-Uk Lee ◽  
Sungwook Yu ◽  
Ji-Soo Kim

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