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Internuclear ophthalmoplegia

MedGen UID:
101820
•Concept ID:
C0152134
•
Disease or Syndrome
Synonyms: Internuclear Ophthalmoplegia; Internuclear Ophthalmoplegias; Ophthalmoplegia, Internuclear; Ophthalmoplegias, Internuclear
SNOMED CT: INO - Internuclear ophthalmoplegia (49823009); Internuclear ophthalmoplegia (49823009); Lhermitte's syndrome (49823009); Bielschowsky-Lutz-Cogan syndrome (49823009); Ophthalmoplegia internuclearis (49823009)
 
HPO: HP:0030773
Monarch Initiative: MONDO:0003417

Definition

An abnormality of conjugate lateral gaze in which the affected eye shows impairment of adduction. The pathognomonic clinical sign of internuclear ophthalmoplegia is an impaired adduction while testing horizontal saccades on the side of the lesion in the ipsilateral medial longitudinal fascicule. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVInternuclear ophthalmoplegia

Professional guidelines

PubMed

Diagnosis and Treatment of Multiple Sclerosis: A Review.
McGinley MP, Goldschmidt CH, Rae-Grant AD
JAMA 2021 Feb 23;325(8):765-779. doi: 10.1001/jama.2020.26858. PMID: 33620411
Wall-eyed bilateral internuclear ophthalmoplegia: review of pathogenesis, diagnosis, prognosis and management.
Wu YT, Cafiero-Chin M, Marques C
Clin Exp Optom 2015 Jan;98(1):25-30. Epub 2014 Oct 12 doi: 10.1111/cxo.12200. PMID: 25308307
Botulinum toxin in the management of internuclear ophthalmoplegia.
Murthy R, Dawson E, Khan S, Adams GG, Lee J
J AAPOS 2007 Oct;11(5):456-9. Epub 2007 May 10 doi: 10.1016/j.jaapos.2007.03.005. PMID: 17498988

Recent clinical studies

Etiology

Ocular motility disorders following coronavirus disease-19 vaccination.
Park KA, Jeon H, Choi DG, Jung JH, Shin HJ, Lee BJ, Moon Y, Lee SY, Lee DC, Cho SY, Kim SJ, Oh SY, Moon S, Oh SY, Choi DD, Choi MY, Kim WJ, Kim US, Lee HJ, Kim Y
Graefes Arch Clin Exp Ophthalmol 2023 Apr;261(4):1127-1139. Epub 2022 Nov 16 doi: 10.1007/s00417-022-05888-z. PMID: 36383278Free PMC Article
Strabismus surgery outcomes for internuclear ophthalmoplegia with exotropia.
Nelson DG, Peragallo JH
Strabismus 2022 Jun;30(2):65-71. Epub 2022 Apr 19 doi: 10.1080/09273972.2022.2061528. PMID: 35438603Free PMC Article
Diplopia After Coronary Revascularization.
Braga J, Neves F, Costa J, Meira D
Acta Med Port 2020 Oct 1;33(10):685-688. doi: 10.20344/amp.11751. PMID: 33135624
Gaze palsy and exotropia in internuclear ophthalmoplegia.
Johkura K, Kudo Y, Amano Y, Kikyo H, Imazeki R, Amari K, Yamamoto M
J Neurol Sci 2015;353(1-2):158-60. Epub 2015 Apr 17 doi: 10.1016/j.jns.2015.04.017. PMID: 25911021
Brainstem pathways for horizontal eye movement: pathologic correlation with MR imaging.
Bae YJ, Kim JH, Choi BS, Jung C, Kim E
Radiographics 2013 Jan-Feb;33(1):47-59. doi: 10.1148/rg.331125033. PMID: 23322826

Diagnosis

Keyhole Aqueduct Syndrome.
Zak I, Hadidchi S, Ross P
Neuroradiology 2024 Sep;66(9):1577-1580. Epub 2024 Jun 24 doi: 10.1007/s00234-024-03408-w. PMID: 38910174
Disorders of vision in multiple sclerosis.
Dhanapalaratnam R, Markoulli M, Krishnan AV
Clin Exp Optom 2022 Jan;105(1):3-12. Epub 2021 Aug 4 doi: 10.1080/08164622.2021.1947745. PMID: 34348598
Nystagmus: Diagnosis, Topographic Anatomical Localization and Therapy.
Strupp ML, Straumann D, Helmchen C
Klin Monbl Augenheilkd 2021 Nov;238(11):1186-1195. Epub 2021 Nov 16 doi: 10.1055/a-1525-0030. PMID: 34784642
Diagnosis and Treatment of Multiple Sclerosis: A Review.
McGinley MP, Goldschmidt CH, Rae-Grant AD
JAMA 2021 Feb 23;325(8):765-779. doi: 10.1001/jama.2020.26858. PMID: 33620411
Internuclear ophthalmoplegia.
Virgo JD, Plant GT
Pract Neurol 2017 Apr;17(2):149-153. Epub 2016 Dec 7 doi: 10.1136/practneurol-2016-001428. PMID: 27927777

Therapy

Strabismus surgery outcomes for internuclear ophthalmoplegia with exotropia.
Nelson DG, Peragallo JH
Strabismus 2022 Jun;30(2):65-71. Epub 2022 Apr 19 doi: 10.1080/09273972.2022.2061528. PMID: 35438603Free PMC Article
Wall-eyed bilateral internuclear ophthalmoplegia associated with etanercept.
Chen T
Pract Neurol 2022 Feb;22(1):71-72. Epub 2021 Aug 5 doi: 10.1136/practneurol-2021-003064. PMID: 34353861
Diagnosis and Treatment of Multiple Sclerosis: A Review.
McGinley MP, Goldschmidt CH, Rae-Grant AD
JAMA 2021 Feb 23;325(8):765-779. doi: 10.1001/jama.2020.26858. PMID: 33620411
Diplopia After Coronary Revascularization.
Braga J, Neves F, Costa J, Meira D
Acta Med Port 2020 Oct 1;33(10):685-688. doi: 10.20344/amp.11751. PMID: 33135624
Visual issues in multiple sclerosis.
Francis CE
Phys Med Rehabil Clin N Am 2013 Nov;24(4):687-702. Epub 2013 Jul 25 doi: 10.1016/j.pmr.2013.06.002. PMID: 24314686

Prognosis

Disorders of vision in multiple sclerosis.
Dhanapalaratnam R, Markoulli M, Krishnan AV
Clin Exp Optom 2022 Jan;105(1):3-12. Epub 2021 Aug 4 doi: 10.1080/08164622.2021.1947745. PMID: 34348598
Diagnosis and Treatment of Multiple Sclerosis: A Review.
McGinley MP, Goldschmidt CH, Rae-Grant AD
JAMA 2021 Feb 23;325(8):765-779. doi: 10.1001/jama.2020.26858. PMID: 33620411
Ocular Motor Manifestations of Multiple Sclerosis.
Nerrant E, Tilikete C
J Neuroophthalmol 2017 Sep;37(3):332-340. doi: 10.1097/WNO.0000000000000507. PMID: 28410279
Wall-eyed bilateral internuclear ophthalmoplegia: review of pathogenesis, diagnosis, prognosis and management.
Wu YT, Cafiero-Chin M, Marques C
Clin Exp Optom 2015 Jan;98(1):25-30. Epub 2014 Oct 12 doi: 10.1111/cxo.12200. PMID: 25308307
Isolated brainstem cysticercosis: a review.
Del Brutto OH, Del Brutto VJ
Clin Neurol Neurosurg 2013 May;115(5):507-11. Epub 2013 Jan 22 doi: 10.1016/j.clineuro.2012.12.026. PMID: 23351839

Clinical prediction guides

Discordant horizontal-torsional nystagmus: a sign of posterior semicircular canal dysfunction.
Lee SU, Kim HJ, Choi JY, Kim BJ, Kim JS
J Neurol 2022 Sep;269(9):5038-5046. Epub 2022 May 11 doi: 10.1007/s00415-022-11155-2. PMID: 35543743
Update on the medial longitudinal fasciculus syndrome.
Lee SH, Kim JM, Kim JS
Neurol Sci 2022 Jun;43(6):3533-3540. Epub 2022 Mar 8 doi: 10.1007/s10072-022-05967-3. PMID: 35258687
Disorders of vision in multiple sclerosis.
Dhanapalaratnam R, Markoulli M, Krishnan AV
Clin Exp Optom 2022 Jan;105(1):3-12. Epub 2021 Aug 4 doi: 10.1080/08164622.2021.1947745. PMID: 34348598
Diagnosis and Treatment of Multiple Sclerosis: A Review.
McGinley MP, Goldschmidt CH, Rae-Grant AD
JAMA 2021 Feb 23;325(8):765-779. doi: 10.1001/jama.2020.26858. PMID: 33620411
Vestibular-evoked myogenic potentials in central vestibular disorders.
Oh SY, Kim HJ, Kim JS
J Neurol 2016 Feb;263(2):210-220. Epub 2015 Aug 5 doi: 10.1007/s00415-015-7860-y. PMID: 26239221

Recent systematic reviews

Ophthalmic manifestations of myelin oligodendrocyte glycoprotein-IgG-associated disorder other than optic neuritis: a systematic review.
Vosoughi AR, Ling J, Tam KT, Blackwood J, Micieli JA
Br J Ophthalmol 2021 Nov;105(11):1591-1598. Epub 2020 Sep 30 doi: 10.1136/bjophthalmol-2020-317267. PMID: 32998905
Internuclear ophthalmoplegia in systemic lupus erythematosus.
Galindo M, Pablos JL, Gómez-Reino JJ
Semin Arthritis Rheum 1998 Dec;28(3):179-86. doi: 10.1016/s0049-0172(98)80034-6. PMID: 9872478

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