MS Views and News Be empowered with MS views and news. To receive The MS BEACON e-Newsletter, CLICK HERE - -

Visit our MS learning channel on YouTube, which provides hundreds of MS educational videos presented by MS Experts from across the USA. Archived here: -- Also please visit our Social media platforms: Facebook, Twitter, and Instagram . Each providing important information for the MS community. Furthermore, scroll down the left side of this blog to learn from the resources and links.

Disclaimer: 'MS Views and News' DOES NOT endorse any products or services found on this blog. It is up to you to seek advice from your healthcare provider. The intent of this blog is to provide information on various medical conditions, medications, treatments, for your personal knowledge and to keep you informed of current health-related issues. It is not a substitute for the advice of your physician. Should you or your family members have any specific medical problem, seek medical care promptly.


Friday, January 18, 2013

Bilateral Internuclear Ophthalmoplegia in Multiple Sclerosis

Getaw Worku Hassen, M.D., Ph.D., and Namita Bhardwaj, M.D.
N Engl J Med 2013; 368:e3January 17, 2013DOI: 10.1056/NEJMicm1200499

A 45-year-old man with multiple sclerosis presented with worsening weakness in his right leg and double vision. Neurologic examination revealed horizontal diplopia during lateral gaze in both eyes. The patient had an adduction deficit in the right eye and nystagmus in the left eye on leftward gaze (Panel A). He also had an adduction deficit in the left eye and nystagmus in the right eye on rightward gaze (Panel B). Upward gaze (Panel C), downward gaze (Panel D), and normal primary position (Panel E) were unremarkable (video). Internuclear ophthalmoplegia is characterized by impaired horizontal eye movement that is caused by a lesion in the medial longitudinal fasciculus, a fiber tract that rises from the abducens nucleus in the pons to the contralateral oculomotor nucleus in the midbrain. Lesions in the medial longitudinal fasciculus result in the failure of adduction on attempted lateral gaze. Any brain-stem syndrome can interrupt the medial longitudinal fasciculus and result in impaired horizontal eye movement, but the most frequent underlying cause is multiple sclerosis. This patient had internuclear ophthalmoplegia in both eyes due to demyelinating lesions. Glucocorticoids were administered intravenously, but the deficits did not resolve. On follow-up at 2 months, the patient's gait had improved, but the internuclear ophthalmoplegia remained.
See Images - click here


If you would like, you can comment to our blog posts
 LIKE this Blog by clicking the LIKE button - top left
 REMAIN up to date with MS News and Education
Visit:  to register

No comments: