Internuclear ophthalmoplegia

Background

• Focal neuro deficit caused by injury or dysfunction of medial longitudinal fasciculus

Clinical Features

Schematic of right internuclear ophthalmoplegia caused by injury to right medial longitudinal fasciculus

• Impaired adduction when attempted to gaze contralaterally to affected eye
• Contralateral eye abducts with nystagmus
• Divergence of eyes--> horizontal diplopia

Differential Diagnosis

• Multiple sclerosis (most common cause in young patients)
• Stroke

Evaluation

• Evaluate for underlying cause based on clinical presentation

Management

• Treat underlying condition