Bilateral ptosis with wall-eyed bilateral internuclear ophthalmoplegia and vertical gaze paralysis

Ljevak, Josip; Mišmaš, Antonija; Poljaković, Zdravka; Habek, Mario

doi:10.1007/s10072-014-1838-x

Cited by 6 publications

(6 citation statements)

References 4 publications

(2 reference statements)

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“…In an inattentive state, mild exotropia is observed on both sides 3) . Disorders of eye movements in our patient were consistent with the characteristics of WEBINO syndrome [1][2][3] . Internuclear ophthalmoplegia is caused by In the forward position, the left eye deviated to the left side (A).…”

Section: Discussionmentioning

confidence: 99%

“…WEBINO syndrome is characterized by bilateral internuclear ophthalmoplegia with alternating exotropia 1,2) , and is usually accompanied by disturbance of convergence 3) . In an inattentive state, mild exotropia is observed on both sides 3) . Disorders of eye movements in our patient were consistent with the characteristics of WEBINO syndrome [1][2][3] .…”

Section: Discussionmentioning

confidence: 99%

“…Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome is a bilateral internuclear ophthalmoplegia with alternating exotropia [1][2][3][4] . The pathogenesis of alternating exotropia in WEBINO syndrome is uncertain.…”

Section: Introductionmentioning

confidence: 99%

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A Case of Wall-Eyed Bilateral Internuclear Ophthalmoplegia (WEBINO) Syndrome Caused by Pontine Infarction

Ogawa

Akimoto

Hara

et al. 2019

Nichidai Igaku Zasshi

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We report a case of a 50-year-old man with wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome caused by pontine infarction. The patient exhibited bilateral internuclear ophthalmoplegia with alternating exotropia and left hemiparesis. In an inattentive state, bilateral mild exotropia was noted. On magnetic resonance imaging, infarcts were detected in the right pontine base and the tegmentum on both sides. On electronystagmogram of saccade, the velocity in adduction and abduction was decreased bilaterally. Furthermore, the velocity in adduction was more decreased than that in abduction bilaterally. This result indicated that the medial longitudinal fasciculus (MLF) and the bilateral paramedian pontine reticular formation (PPRF) were impaired bilaterally in predominance of the MLF. Inhibition of the lateral rectus muscle depends on inhibitory burst neurons connected to the contralateral PPRF. This inhibitory function was considered to be related to adjustment of the forward gaze in the lateral eye.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Case of Wall-Eyed Bilateral Internuclear Ophthalmoplegia (WEBINO) Syndrome Caused by Pontine Infarction

Ogawa

Akimoto

Hara

et al. 2019

Nichidai Igaku Zasshi

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“…Studies have shown that the disease is often associated with brainstem ischemia and hydrocephalus, immunotherapy of tumors, and diseases such as multiple sclerosis. This study summarized 39 case reports, including 42 WEBINO patients (Inocencio and Ballecer, 1985;Lana et al, 1990;Fay and Strominger, 1999;Korkmaz et al, 2002;Ozer et al, 2005;Chen and Lin, 2007;Kim et al, 2008;Matsumoto et al, 2008Matsumoto et al, , 2019Ushio et al, 2008;Jacob et al, 2010;Sierra-Hidalgo et al, 2010;Shinoda et al, 2011;Beh and Frohman, 2012;Jadhav and Prasad, 2012;Sakamoto et al, 2012;Bar et al, 2014;Chakravarthi et al, 2014;de Mora et al, 2014;Mathis et al, 2014;Muralidhar et al, 2014;Nakajima et al, 2014;Toufeeq and Dave, 2014;Agarwal et al, 2015;Ljevak et al, 2015;Man et al, 2015;de Souza et al, 2017;Sajjadi et al, 2017;Zou and Chen, 2017;Keereman et al, 2018;Papageorgiou et al, 2018;Im et al, 2020;Vázquez-Justes et al, 2020;Yazdi et al, 2020;Ansari et al, 2021;Jo et al, 2021;Petrik et al, 2021;Sinha et al, 2021;Wako et al, 2022). The age range of the ...…”

Section: Discussionmentioning

confidence: 99%

Case report: A variant of wall-eyed bilateral internuclear ophthalmoplegia from unilateral pons infarction

2022

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Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) is an uncommon ocular motility disorder that encompasses the following clinical signs: bilateral adduction deficits, bilateral abducting nystagmus, convergence lost, and a large angle exotropia in primary gaze. Here we report a case of a 55-year-old man presenting with atypical WEBINO syndrome with unilateral exotropia. The coverage test was used to record the patient's alternating exotropia. The patient experienced diplopia and ophthalmoplegia and was admitted to our hospital 3 days after the onset of the double vision. Neurologic examination showed left eye exotropia and bilateral internuclear ophthalmoplegia with impaired convergence. Vertical saccades of the left eye were also limited. Consequently, an MRI scan suggested an acute infarction in the left of the pontine tegmentum. The patient was finally diagnosed with pons infarction and was treated with anticoagulation and anti-platelet aggregation therapy.

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“…A literature search of PubMed using the keyword "wall-eye bilateral internuclear ophthalmoplegia" identi ed 19 cases [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] in which lesion position were documented. Ten cases had lesions in the midbrain, four in the midbrain and pons, and ve in the pons.…”

Section: Discussionmentioning

confidence: 99%

Wall-Eyed Bilateral Internuclear Ophthalmoplegia Caused by Unilateral Subpontine Infarction: A Case Report

Wang¹,

Jiang

et al. 2021

Preprint

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Background： Wall-eyed bilateral internuclear ophthalmoplegia syndrome (WEBINO) is a rare disorder comprising bilateral exotropia, bilateral internuclear ophthalmoplegia, and impaired convergence. It is usually caused by a midbrain lesion. Case presentation ：We describe a rare case of WEBINO, with the lesion located in the lower pons, in a 69-year-old man with acute ischemic stroke. Conclusions ：Our report alerts physicians to the possibility of bilateral WEBINO due to unilateral infarction.

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Bilateral ptosis with wall-eyed bilateral internuclear ophthalmoplegia and vertical gaze paralysis

Cited by 6 publications

References 4 publications

A Case of Wall-Eyed Bilateral Internuclear Ophthalmoplegia (WEBINO) Syndrome Caused by Pontine Infarction

A Case of Wall-Eyed Bilateral Internuclear Ophthalmoplegia (WEBINO) Syndrome Caused by Pontine Infarction

Case report: A variant of wall-eyed bilateral internuclear ophthalmoplegia from unilateral pons infarction

Wall-Eyed Bilateral Internuclear Ophthalmoplegia Caused by Unilateral Subpontine Infarction: A Case Report

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