Two Cases of True and Pseudo-internuclear Ophthalmoplegia with Bilateral Exodeviation.

Kim, Dong Seob; Sohn, Yong Ho; Kim, Seung Hyun; Choe, Jun Kiu

Case Report

Journal of the Korean Ophthalmological Society 1995;36(12):2237-2242.
Published online December 1, 1995.

Two Cases of True and Pseudo-internuclear Ophthalmoplegia with Bilateral Exodeviation.

Dong Seob Kim, Yong Ho Sohn, Seung Hyun Kim, Jun Kiu Choe

¹Department of Ophthalmology, College of Medicine, Han Yang University, Seoul, Korea.
²Department of Neurology, College of Medicine, Han Yang University, Seoul, Korea.

양안 외측편위를 동반한 진성 핵간마비 1 예와 가성 핵간마비 1 예

김동섭(Dong Seob Kim),손용호(Yong Ho Sohn),김승현(Seung Hyun Kim),최준규(Jun Kiu Choe)

Abstract

Internuclear ophthalmoplegia(INO) is characterized by the adduction deficit on lateral gaze associated with dissociated nystagmus of an abducting eye and caused by the lesion in the medial longitudinal fasciculus(MLF). It occurs unilaterally or bilaterally in infarction of brain stem and multiple sclerosis. Ocular myasthenia is a localized form of myasthenia involving extraocular, levator palpebrae perioris, and/or orbicularis oculi muscles. It is frequently confused with a variety of ocular mortility disorders including INO. We experienced 2 patients who had bilateral wall-eyes and diplopia. One was a true bilateral INO due to hypertensive brain stem infarction(Wall-eyed bilateral INO) and the other was a myasthenic bilateral pseudo-INO. Diagnosis was made by Tensilon test, repetitive nerve stimulation test of orbicularis oculi muscles, and serum antibody assay in latter case.

Key Words: Internuclear ophthalmoplegia;Ocular myasthenia;Pseudointernuclear ophthalmoplegia;Wall-eyed bilateral internuclear ophthamoplegia