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Internuclear ophthalmoplegia
Neuro-Ophthalmology
Key Points
- •INO = lesion of the MLF → impaired adduction of ipsilateral eye + dissociated abduction nystagmus of contralateral eye + preserved convergence
- •Bilateral INO in young patient = MS until proven otherwise (virtually pathognomonic); unilateral INO in elderly = brainstem stroke
- •Convergence is preserved because the convergence pathway bypasses the MLF - the key differentiator from CN3 palsy
- •One-and-a-half syndrome = INO + ipsilateral gaze palsy; only abduction of contralateral eye remains
- •Saccadic velocity testing is the most sensitive method to detect subtle/partial INO (adduction lag)
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17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations