Internuclear opthalmoplegia - Revision history

ClaireLewis: Redirected page to Internuclear ophthalmoplegia

2019-10-02T22:36:43Z

Redirected page to Internuclear ophthalmoplegia

← Older revision		Revision as of 22:36, 2 October 2019
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	~~==Background==~~		#REDIRECT[[Internuclear ophthalmoplegia]]
	[[~~File:Ino v2.png\|thumbnail\|~~Internuclear ~~opthalmoplegia, courtesy of sketchy medicine]]~~

	*Disruption of conjugate gaze.
	*Results in [[diplopia]] when looking contralateral (to affected eye).
	*Localized to Midbrain or Pons.
	*Paramedian Pontine Reticular Formation (PPRF) is the conjugate gaze center for horizontal eye movements. Innervates ipsilateral Abducens (CN VI) nucleus. Abducens nucleus signals ipsilateral lateral rectus to contract and sends a second via MLF to contralateral oculomotor (CN III) nucleus, causing contraction on the contralateral medial rectus.
	*Lesions in the Medial Longitudinal Fasiculus (MLF) result in intranuclear ophthalmoplegia ~~(INO).~~
	*Associated with one and one-half syndrome (lesion involving the PPRF and ipsilateral MLF)

	~~==Clinical Features==~~
	*Weakness in adduction of affected eye with limitation in horizontal gaze.
	*May result in horizontal [[diplopia]]
	*Horizontal [[nystagmus]] in unaffected eye
	*Convergence remains intact (differentiates CN III palsy from INO)

	~~==Differential Diagnosis==~~
	*[[Multiple sclerosis]] (often presents with bilateral internuclear ophthalmoplegia)
	*[[CVA\|Cerebrovascular disease]]
	*[[brain tumor\|Malignancy]] located in brainstem and 4th ventricle
	*[[third nerve palsy\|CN III palsy]]

	~~==Evaluation==~~
	*Neurologic exam
	*The use of optokinetic tape is highly sensitive for testing for INO
	*[[brain MRI]]

	~~==Management==~~
	*Symptoms will often resolve on their own. Patients with cerebrovascular disease are less likely to have recovery.
	*Patching of eye can aid in relief of diplopia
	*Diframpadine, potassium channel blocker, has been used in patients with demyelinating disease

	~~==References==~~
	~~<references/>~~
	~~Ropper A, Klein J, Samuels M. Adams and Victor's Principles of Neurology 10th Edition. McGraw-Hill Education / Medical; 2014.~~
	~~<references/>~~
	~~Serra A, Skelly MM, Jacobs JB, et al. Improvement of internuclear ophthalmoparesis in multiple sclerosis with dalfampridine. Neurology 2014; 83:192.~~


	~~[[Category:Neurology]]~~
	~~[[Category:Symptoms~~]]

ClaireLewis at 22:32, 2 October 2019

2019-10-02T22:32:33Z

← Older revision		Revision as of 22:32, 2 October 2019
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	==Clinical Features==		==Clinical Features==
	*Weakness in adduction of affected eye with limitation in horizontal gaze.		*Weakness in adduction of affected eye with limitation in horizontal gaze.
	*May result in horizontal diplopia		*May result in horizontal [[diplopia]]
	*Horizontal nystagmus in unaffected eye		*Horizontal [[nystagmus]] in unaffected eye
	*Convergence remains intact (differentiates CN III palsy from INO)		*Convergence remains intact (differentiates CN III palsy from INO)

	==Differential Diagnosis==		==Differential Diagnosis==
	*Multiple ~~Sclerosis~~ (often presents with bilateral internuclear ophthalmoplegia)		*[[Multiple sclerosis]] (often presents with bilateral internuclear ophthalmoplegia)
	*Cerebrovascular disease		*[[CVA\|Cerebrovascular disease]]
	*Malignancy located in brainstem and 4th ventricle		*[[brain tumor\|Malignancy]] located in brainstem and 4th ventricle
	*CN III palsy		*[[third nerve palsy\|CN III palsy]]

	==Evaluation==		==Evaluation==
	*Neurologic exam		*Neurologic exam
	*The use of optokinetic tape is highly sensitive for testing for INO		*The use of optokinetic tape is highly sensitive for testing for INO
	*MRI		*[[brain MRI]]

	==Management==		==Management==
	*~~Symtoms~~ will often resolve on their own. Patients with cerebrovascular disease are less likely to have recovery.		*Symptoms will often resolve on their own. Patients with cerebrovascular disease are less likely to have recovery.
	*Patching of eye can aid in relief of diplopia		*Patching of eye can aid in relief of diplopia
	*Diframpadine, potassium channel blocker, has been used in patients with demyelinating disease		*Diframpadine, potassium channel blocker, has been used in patients with demyelinating disease

Devan91: /* Background */

2017-08-04T05:09:39Z

Background

← Older revision		Revision as of 05:09, 4 August 2017
Line 2:		Line 2:
	[[File:Ino v2.png\|thumbnail\|Internuclear opthalmoplegia, courtesy of sketchy medicine]]		[[File:Ino v2.png\|thumbnail\|Internuclear opthalmoplegia, courtesy of sketchy medicine]]

	*~~One and one-half syndrome~~		*Disruption of conjugate gaze.
	*Affected eye has impaired adduction when looking contralateral (to affected eye)		*Results in [[diplopia]] when looking contralateral (to affected eye).
	*Results in [[diplopia]] when looking contralateral (to affected eye)		*Localized to Midbrain or Pons.
	*~~Usually results from~~ a lesion in the ~~brainstem~~		*Paramedian Pontine Reticular Formation (PPRF) is the conjugate gaze center for horizontal eye movements. Innervates ipsilateral Abducens (CN VI) nucleus. Abducens nucleus signals ipsilateral lateral rectus to contract and sends a second via MLF to contralateral oculomotor (CN III) nucleus, causing contraction on the contralateral medial rectus.
			*Lesions in the Medial Longitudinal Fasiculus (MLF) result in intranuclear ophthalmoplegia (INO).
			*Associated with one and one-half syndrome (lesion involving the PPRF and ipsilateral MLF)

	==Clinical Features==		==Clinical Features==
			*Weakness in adduction of affected eye with limitation in horizontal gaze.
			*May result in horizontal diplopia
			*Horizontal nystagmus in unaffected eye
			*Convergence remains intact (differentiates CN III palsy from INO)

	==Differential Diagnosis==		==Differential Diagnosis==
			*Multiple Sclerosis (often presents with bilateral internuclear ophthalmoplegia)
			*Cerebrovascular disease
			*Malignancy located in brainstem and 4th ventricle
			*CN III palsy

	==Evaluation==		==Evaluation==
			*Neurologic exam
			*The use of optokinetic tape is highly sensitive for testing for INO
			*MRI

	==Management==		==Management==
			*Symtoms will often resolve on their own. Patients with cerebrovascular disease are less likely to have recovery.
			*Patching of eye can aid in relief of diplopia
	~~==Disposition==~~		*Diframpadine, potassium channel blocker, has been used in patients with demyelinating disease


	~~==See Also==~~


	==References==		==References==
	<references/>		<references/>
			Ropper A, Klein J, Samuels M. Adams and Victor's Principles of Neurology 10th Edition. McGraw-Hill Education / Medical; 2014.
			<references/>
			Serra A, Skelly MM, Jacobs JB, et al. Improvement of internuclear ophthalmoparesis in multiple sclerosis with dalfampridine. Neurology 2014; 83:192.


	[[Category:Neurology]]		[[Category:Neurology]]
	[[Category:Symptoms]]		[[Category:Symptoms]]

Mholtz: Text replacement - "* " to "*"

2017-07-24T01:12:55Z

Text replacement - "* " to "*"

← Older revision		Revision as of 01:12, 24 July 2017
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	*One and one-half syndrome		*One and one-half syndrome
	* Affected eye has impaired adduction when looking contralateral (to affected eye)		*Affected eye has impaired adduction when looking contralateral (to affected eye)
	* Results in [[diplopia]] when looking contralateral (to affected eye)		*Results in [[diplopia]] when looking contralateral (to affected eye)
	*Usually results from a lesion in the brainstem		*Usually results from a lesion in the brainstem

Mholtz at 01:42, 27 May 2017

2017-05-27T01:42:53Z

@@ Line 1: / Line 1: @@
 ==Background==
 *One and one-half syndrome
 * Affected eye has impaired adduction when looking contralateral (to affected eye)
@@ Line 5: / Line 7: @@
 *Usually results from a lesion in the brainstem
-[[File:Ino v2.png|thumbnail|Internuclear opthalmoplegia, courtesy of sketchy medicine]]
+==Clinical Features==
 [[Category:Neurology]]

Zipdoc at 06:03, 27 March 2017

2017-03-27T06:03:58Z

← Older revision		Revision as of 06:03, 27 March 2017
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	[[File:Ino v2.png\|thumbnail\|Internuclear opthalmoplegia, courtesy of sketchy medicine]]		[[File:Ino v2.png\|thumbnail\|Internuclear opthalmoplegia, courtesy of sketchy medicine]]

			[[Category:Neurology]]

Unenthusiastic: /* Background */

2017-03-17T13:54:42Z

Background

← Older revision		Revision as of 13:54, 17 March 2017
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	*One and one-half syndrome		*One and one-half syndrome
	* Affected eye has impaired adduction when looking contralateral (to affected eye)		* Affected eye has impaired adduction when looking contralateral (to affected eye)
	* Results in diplopia when looking contralateral (to affected eye)		* Results in [[diplopia]] when looking contralateral (to affected eye)
	*Usually results from a lesion in the brainstem		*Usually results from a lesion in the brainstem

	[[File:Ino v2.png\|thumbnail\|Internuclear opthalmoplegia, courtesy of sketchy medicine]]		[[File:Ino v2.png\|thumbnail\|Internuclear opthalmoplegia, courtesy of sketchy medicine]]

Unenthusiastic: /* Background */

2017-03-17T13:54:00Z

Background

← Older revision		Revision as of 13:54, 17 March 2017
Line 1:		Line 1:
	==Background==		==Background==
	*One and one-half syndrome		*One and one-half syndrome
			* Affected eye has impaired adduction when looking contralateral (to affected eye)
			* Results in diplopia when looking contralateral (to affected eye)
			*Usually results from a lesion in the brainstem

	[[File:Ino v2.png\|thumbnail\|Internuclear opthalmoplegia, courtesy of sketchy medicine]]		[[File:Ino v2.png\|thumbnail\|Internuclear opthalmoplegia, courtesy of sketchy medicine]]

Kxl328 at 00:04, 27 February 2017

2017-02-27T00:04:53Z

← Older revision		Revision as of 00:04, 27 February 2017
Line 1:		Line 1:
	==Background==		==Background==
			*One and one-half syndrome

			[[File:Ino v2.png\|thumbnail\|Internuclear opthalmoplegia, courtesy of sketchy medicine]]

Kxl328: Created page with "==Background=="

2017-02-27T00:03:31Z

Created page with "==Background=="

New page

==Background==