Isolated unilateral internuclear ophthalmoplegia following head injury: Findings in magnetic resonance imaging

Abstract

Internuclear ophthalmoplegia (INO) is most commonly caused by multiple sclerosis or cerebrovascular diseases. The authors report on two cases with isolated unilateral INO after head trauma with verified anatomical lesion in the brainstem in the region of the medial longitudinal fascicle. In both cases a small contusion could be detected in the MRI. Concomitant brainstem injury was excluded with brainstem auditory evoked potentials (BAEP). A review of the world literature disclosed only one case with isolated posttraumatic INO with magnetic resonance imaging of the lesion. In posttraumic disorders of eye motility emphasis should be placed on clinical diagnosis in combination with neuroradiologic and electrophysiologic examination to achieve accurate topographical identification of the lesion actually being responsible for the symptomatology.

Key Words:

• Internuclear ophthalmoplegia
• magnetic resonance imaging
• head injury
• brainstem auditory evoked potentials