Bilateral Internuclear Ophthalmoplegia in a Young Woman with Vertebral Artery Dissection
Background: Internuclear ophthalmoplegia (INO) is an eye movement disorder caused by a lesion in the medial longitudinal fasciculus (MLF) located in the midbrain. Adduction paralysis of both eyes and bilateral abduction nystagmus are the main features of INO[1]. Case presentation: A 29-year-old His...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SMC MEDIA SRL
2019-06-01
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| Series: | European Journal of Case Reports in Internal Medicine |
| Subjects: | |
| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/1105 |
| _version_ | 1819103849542057984 |
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| author | Omar Cárdenas Enrique Gomez Mariana Marcín Adib Jorge de Sarachaga Verónica Sánchez Juan Manuel Calleja |
| author_facet | Omar Cárdenas Enrique Gomez Mariana Marcín Adib Jorge de Sarachaga Verónica Sánchez Juan Manuel Calleja |
| author_sort | Omar Cárdenas |
| collection | DOAJ |
| description | Background: Internuclear ophthalmoplegia (INO) is an eye movement disorder caused by a lesion in the medial longitudinal fasciculus (MLF) located in the midbrain. Adduction paralysis of both eyes and bilateral abduction nystagmus are the main features of INO[1].
Case presentation: A 29-year-old Hispanic woman was admitted to the emergency department complaining of an intense holocranial headache lasting 9 days, associated with nausea and vomiting. She was discharged home with resolution of the headache but persistence of symptoms. However, she subsequently developed horizontal diplopia and gait abnormalities. She was readmitted to hospital because of anomalous eye movements and conjugate gaze palsy, manifested as bilateral INO. Magnetic resonance angiography (MRA) findings were consistent with dissection of the left V4 vertebral artery with multiple brain infarcts in the superior cerebellar artery territory, comprising both MLF tracts.
Conclusions: In young adults, bilateral INO is normally caused by demyelinating disease. In other patients, common causes include trauma, infections and autoimmune diseases with neurological symptoms. Vascular disease is implicated in over a third of cases. |
| first_indexed | 2024-12-22T01:57:00Z |
| format | Article |
| id | doaj.art-14cac1585a664c83ab679d3f8e67c5c3 |
| institution | Directory Open Access Journal |
| issn | 2284-2594 |
| language | English |
| last_indexed | 2024-12-22T01:57:00Z |
| publishDate | 2019-06-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj.art-14cac1585a664c83ab679d3f8e67c5c32022-12-21T18:42:45ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942019-06-0110.12890/2019_0011051105Bilateral Internuclear Ophthalmoplegia in a Young Woman with Vertebral Artery DissectionOmar Cárdenas0Enrique Gomez1Mariana Marcín2Adib Jorge de Sarachaga3Verónica Sánchez4Juan Manuel Calleja5Neurology Department, National Institute of Neurology and Neurosurgery, Mexico City, MexicoNeurology Department, National Institute of Neurology and Neurosurgery, Mexico City, MexicoNeurology Department, National Institute of Neurology and Neurosurgery, Mexico City, MexicoNeurology Department, National Institute of Neurology and Neurosurgery, Mexico City, MexicoNeurology Department, National Institute of Neurology and Neurosurgery, Mexico City, MexicoNeurology Department, National Institute of Neurology and Neurosurgery, Mexico City, MexicoBackground: Internuclear ophthalmoplegia (INO) is an eye movement disorder caused by a lesion in the medial longitudinal fasciculus (MLF) located in the midbrain. Adduction paralysis of both eyes and bilateral abduction nystagmus are the main features of INO[1]. Case presentation: A 29-year-old Hispanic woman was admitted to the emergency department complaining of an intense holocranial headache lasting 9 days, associated with nausea and vomiting. She was discharged home with resolution of the headache but persistence of symptoms. However, she subsequently developed horizontal diplopia and gait abnormalities. She was readmitted to hospital because of anomalous eye movements and conjugate gaze palsy, manifested as bilateral INO. Magnetic resonance angiography (MRA) findings were consistent with dissection of the left V4 vertebral artery with multiple brain infarcts in the superior cerebellar artery territory, comprising both MLF tracts. Conclusions: In young adults, bilateral INO is normally caused by demyelinating disease. In other patients, common causes include trauma, infections and autoimmune diseases with neurological symptoms. Vascular disease is implicated in over a third of cases.https://www.ejcrim.com/index.php/EJCRIM/article/view/1105Bilateral Internuclear ophtalmolegiaartery dissectionvertebral artery |
| spellingShingle | Omar Cárdenas Enrique Gomez Mariana Marcín Adib Jorge de Sarachaga Verónica Sánchez Juan Manuel Calleja Bilateral Internuclear Ophthalmoplegia in a Young Woman with Vertebral Artery Dissection European Journal of Case Reports in Internal Medicine Bilateral Internuclear ophtalmolegia artery dissection vertebral artery |
| title | Bilateral Internuclear Ophthalmoplegia in a Young Woman with Vertebral Artery Dissection |
| title_full | Bilateral Internuclear Ophthalmoplegia in a Young Woman with Vertebral Artery Dissection |
| title_fullStr | Bilateral Internuclear Ophthalmoplegia in a Young Woman with Vertebral Artery Dissection |
| title_full_unstemmed | Bilateral Internuclear Ophthalmoplegia in a Young Woman with Vertebral Artery Dissection |
| title_short | Bilateral Internuclear Ophthalmoplegia in a Young Woman with Vertebral Artery Dissection |
| title_sort | bilateral internuclear ophthalmoplegia in a young woman with vertebral artery dissection |
| topic | Bilateral Internuclear ophtalmolegia artery dissection vertebral artery |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/1105 |
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