A rare cause for visual symptoms in multiple sclerosis: posterior internuclear ophthalmoplegia of Lutz, a historical misnomer

Bijvank, Jenny A. Nij; Balk, Lisanne J.; Tan, H. Stevie; Uitdehaag, Bernard M. J.; Rijn, L.J. van; Petzold, Axel

doi:10.1007/s00415-017-8412-4

Cited by 5 publications

(3 citation statements)

References 10 publications

(10 reference statements)

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“…At first glance it may seem that the VDI peak velocity, on which we and others reported before, 2–4,18 already covers the essential pathologic feature (adduction delay). The limitation is that the VDI peak velocity considers one moment in time.…”

Section: Discussionmentioning

confidence: 54%

Diagnosing and quantifying a common deficit in multiple sclerosis

et al. 2019

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ObjectiveWe present an objective and quantitative approach for diagnosing internuclear ophthalmoplegia (INO) in multiple sclerosis (MS).MethodsA validated standardized infrared oculography protocol (DEMoNS [Demonstrate Eye Movement Networks with Saccades]) was used for quantifying prosaccades in patients with MS and healthy controls (HCs). The versional dysconjugacy index (VDI) was calculated, which describes the ratio between the abducting and adducting eye. The VDI was determined for peak velocity, peak acceleration, peak velocity divided by amplitude, and area under the curve (AUC) of the saccadic trajectory. We calculated the diagnostic accuracy for the several VDI parameters by a receiver operating characteristic analysis comparing HCs and patients with MS. The National Eye Institute Visual Function Questionnaire–25 was used to investigate vision-related quality of life of MS patients with INO.ResultsTwo hundred ten patients with MS and 58 HCs were included. The highest diagnostic accuracy was achieved by the VDI AUC of 15° horizontal prosaccades. Based on a combined VDI AUC and peak velocity divided by amplitude detection, the prevalence of an INO in MS calculated to 34%. In the INO group, 35.2% of the patients with MS reported any complaints of double vision, compared to 18.4% in the non-INO group (p = 0.010). MS patients with an INO had a lower overall vision-related quality of life (median 89.9, interquartile range 12.8) compared to patients without an INO (median 91.8, interquartile range 9.3, p = 0.011).ConclusionsThis study provides an accurate quantitative and clinically relevant definition of an INO in MS. This infrared oculography-based INO standard will require prospective validation. The high prevalence of INO in MS provides an anatomically well described and accurately quantifiable model for treatment trials in MS.

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Section: Discussionmentioning

confidence: 54%

Diagnosing and quantifying a common deficit in multiple sclerosis

et al. 2019

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“…In 1923, Anton Lutz first described the characteristic dual eye movement findings of ipsilateral abduction slowing and contralateral dissociated adducting nystagmus-the converse of a typical INO (2). He originally called this a "posterior INO" based on a mistaken assumption that posterior supranuclear fibers for horizontal gaze divided into 2 branches, one synapsing with lateral rectus neurons and another synapsing with contralateral medial rectus neurons (3).…”

Section: Interpretation Of Findingsmentioning

confidence: 99%

Pseudoabducens Palsy of Lutz

Sharma¹,

Kim²,

Fraser³

2022

Journal of Neuro-Ophthalmology

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A 40-year-old woman presented with a 2-year history of nonfluctuating diplopia on left gaze. Her medical history included 3 years of left facial numbness. On examination, visual acuity, color vision, pupils, lids, funduscopic examination, and automated visual fields were normal.Smooth pursuit in the right eye was normal, whereas the left eye had very slight abduction limitation. Rightward saccades from primary position (Fig. 1A) to right gaze (Fig. 1B) were normal, but there was a striking abduction

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“…The symptoms include mental, psychiatric, and physical problems. 4 The symptoms may disappear between attacks. 5 Currently, treatments are provided to improve patients' functioning.…”

Section: Introductionmentioning

confidence: 99%

Synthetic Minority Oversampling Technique and Fractal Dimension for Identifying Multiple Sclerosis

Zhang

Phillips

et al. 2017

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Multiple sclerosis (MS) is a severe brain disease. Early detection can provide timely treatment. Fractal dimension can provide statistical index of pattern changes with scale at a given brain image. In this study, our team used susceptibility weighted imaging technique to obtain 676 MS slices and 880 healthy slices. We used synthetic minority oversampling technique to process the unbalanced dataset. Then, we used Canny edge detector to extract distinguishing edges. The Minkowski-Bouligand dimension was a fractal dimension estimation method and used to extract features from edges. Single hidden layer neural network was used as the classifier. Finally, we proposed a three-segment representation biogeography-based optimization to train the classifier. Our method achieved a sensitivity of 97.78±1.29%, a specificity of 97.82±1.60% and an accuracy of 97.80±1.40%. The proposed method is superior to seven state-of-the-art methods in terms of sensitivity and accuracy.

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A rare cause for visual symptoms in multiple sclerosis: posterior internuclear ophthalmoplegia of Lutz, a historical misnomer

Cited by 5 publications

References 10 publications

Diagnosing and quantifying a common deficit in multiple sclerosis

Diagnosing and quantifying a common deficit in multiple sclerosis

Pseudoabducens Palsy of Lutz

Synthetic Minority Oversampling Technique and Fractal Dimension for Identifying Multiple Sclerosis

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