A brainstem lesion of any type that involves the medial longitudinal fasciculus ( MLF) can cause internuclear ophthalmoplegia (INO). This primarily affects. Internuclear ophthalmoplegia is an ocular movement disorder caused by a lesion of the medial longitudinal fasciculus. It is characterized by. Internuclear ophthalmoplegia is the inability to move both your eyes together when looking to the side. It can affect one or both of your eyes.

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Internuclear ophthalmoplegia

D ICD – Pearls and Other Issues A simple physical examination is often all that is required to diagnose a case of internuclear ophthalmoplegia. Kirkham TH, Katsarkas A.

A stroke can be called ischemia, or an ischemic attack. Author Information Authors Iternuclear B. Not reviewed add Contributing Editors: Up to 75 percent of people are likely to show some visible damage to the medial longitudinal fasciculus nerve fiber on an MRI scan. Additionally, the adduction deficit and contralateral abducting nystagmus is evident.

A syndrome that consists of an INO in one eye combined with an ipsilateral CN VI fascicular involvement with sparing of the sixth nerve nucleus. Wall M, Wray SH.

Internuclear ophthalmoplegia

Original article contributed by: Chorea Dystonia Parkinson’s disease. Retrieved Aug 8, from www. Support Center Support Center.

Thus, the MLF allows for coordination of eye movements between both eyes and allows both eyes to move conjugately in the same direction of gaze [1].


What Causes Diplopia Double Vision? Show details Treasure Island FL: Less common causes for an INO include traumatic, neoplastic, inflammatory e.

Internuclear Ophthalmoplegia as an isolated or predominant symptom of brainstem infarction.

Internuclear Ophthalmoplegia – EyeWiki

Questions To access free multiple choice questions on this topic, click here. Learn more about the possible causes of monocular and binocular diplopia double visionwhen to call your doctor, and treatment options.

So chances are, you may benefit at some point in your life from talking…. Improved neuronal conduction along MLF has been discussed as a possible explanation for this effect seen [12]. Increased innervations to the medial rectus muscle are accompanied by an increase in innervation to its yoke muscle, the contralateral lateral rectus, resulting in nystagmus.

Skew deviation is a vertical misalignment of eyes caused by asymmetrical disruption of supranuclear input from the otolithic organs of the inner ear. Typically, the paramedian pontine reticular formation PPRF receives information from the higher cortical centers such as the frontal eye fields, occipital and parietal lobes and the superior colliculus.

When looking to the left, your right eye will not turn as far as ophthalmoolegia should. In older people, stroke is a ophthalmoplegka common etiology.

Schematic demonstrating right internuclear ophthalmoplegia, caused by injury of the right medial longitudinal fasciculus. This page was last modified on December 19,at Damage to the MLF disrupts its ability to conduct high-frequency signals sent from the paramedian pontine reticular formation, resulting in slow adducting saccades.

From worsening anxiety to making depression more likely, kphthalmoplegia is seriously harmful to your mental health. It is characterized by impaired adduction of the ipsilateral eye with nystagmus of the abducting eye. The disorder is pohthalmoplegia by injury or dysfunction in the medial longitudinal fasciculus MLFa heavily myelinated tract that allows conjugate eye movement by connecting the paramedian pontine reticular formation PPRF – abducens nucleus complex of the contralateral side to the oculomotor nucleus of the ipsilateral side.


Wall-eyed bilateral internuclear ophthalmoplegia in a patient with progressive supranuclear palsy. Demyelination due to multiple sclerosis is the more common cause in younger populations [4].

Introduction Internuclear ophthalmoplegia is an ocular movement disorder caused by a lesion of the medial longitudinal fasciculus. Inflammatory encephalitis affecting the brainstem e. The Neurology of Eye Movements, 3rd ed. It is a paired white matter tract passing close to the midline, through the brainstem lying ventral to the cerebral aqueduct in the midbrain and the fourth ventricle in the pons and medulla.

Notably, the absence of concomitant neurological signs, such as vertigo, ataxia, sensory symptoms, dysarthria, facial palsy, or pyramidal tract dysfunction, has been shown to be significantly correlated with a more rapid recovery [1, 5]. About half of the people with INO will experience only these mild symptoms. The signs of INO may be so clear that little testing is needed to confirm the diagnosis. Review of imaging, anatomy, pathophysiology and differential diagnosis.