Document Detail

Internuclear ophthalmoplegia: unusual causes in 114 of 410 patients.
MedLine Citation:
PMID:  15883257     Owner:  NLM     Status:  MEDLINE    
Internuclear ophthalmoplegia (INO) is a sign of exquisite localizing value, often due to either multiple sclerosis or infarction. To demonstrate that unusual causes of INO are more common than the 11% reported in previous series, this review considers a case series of 410 inpatients whom I personally examined during a 33-year period. In this series, the cause of INO was infarction in 157 patients (38%), multiple sclerosis in 139 (34%), and unusual causes in 114 (28%). Unusual causes included trauma (20 cases), tentorial herniation (20 cases), infection (17 cases), tumor (17 cases), iatrogenic injury (12 cases), hemorrhage (13 cases), vasculitis (7 cases), and miscellaneous (8 cases). Internuclear ophthalmoplegia was unilateral in 136 of the infarct cases (87%), 38 of those with multiple sclerosis (27%), and 48 of the unusual cases (42%). Because unusual causes compose more than one quarter of the cases, the differential diagnosis of INO should be tripartite: multiple sclerosis, stroke, and other causes.
James R Keane
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Archives of neurology     Volume:  62     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-10     Completed Date:  2005-06-17     Revised Date:  2006-05-22    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  714-7     Citation Subset:  AIM; IM    
Department of Neurology, University of Southern California School of Medicine, Los Angeles, CA 90033, USA.
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MeSH Terms
Brain Stem Infarctions / complications*
Diagnosis, Differential
Longitudinal Studies
Multiple Sclerosis / complications*
Ophthalmoplegia / epidemiology*,  etiology*
Comment In:
Arch Neurol. 2006 Apr;63(4):626; author reply 626-7   [PMID:  16606784 ]

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