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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
Cranial nerve, brainstem and cerebellar syndromes in the differential diagnosis of multiple sclerosis.
Zaffaroni M, Baldini SM, Ghezzi A
Neurol Sci 2001 Nov;22 Suppl 2:S74-8. doi: 10.1007/s100720100039. PMID: 11794483

Recent clinical studies

Etiology

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
Pediatric internuclear ophthalmoplegia.
Rizzo JL, Lloyd M, O'Hara MA
J Neuroophthalmol 2013 Jun;33(2):134-6. doi: 10.1097/WNO.0b013e3182881ad7. PMID: 23470988
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

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
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
Internuclear ophthalmoplegia: pathophysiology and diagnosis.
Zee DS
Baillieres Clin Neurol 1992 Aug;1(2):455-70. PMID: 1344079

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

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
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
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
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

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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