Combined Trochlear Nerve Palsy and Internuclear Ophthalmoplegia

Vanooteghem, P; Dehaene, I.; Zandycke, Michel Van; Casselman, Jan

doi:10.1001/archneur.1992.00530250112025

Cited by 36 publications

(11 citation statements)

References 5 publications

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Section: Discussionmentioning

confidence: 99%

“…Internuclear ophthalmoplegias can be identified by adduction deficits in attempted left or right gazes and correlate to an ipsilateral medial longitudinal fasciculus lesion . It can be common for the abducting eye to show signs of nystagmus, but this is not always clinically encountered . The medial longitudinal fasciculus travels from the contralateral abducens nucleus in the lower pons and connects to the contralateral oculomotor nerve subnucleus of the medial rectus muscle enabling horizontal gaze to occur .…”

Section: Discussionmentioning

confidence: 99%

“…Trochlear nerve palsies and internuclear ophthalmoplegias are well documented neuro‐ophthalmological conditions . However, cases of both of these conditions occurring together in the same patient are rare . A case of concurrent internuclear ophthalmoplegia and contralateral trochlear nerve palsy follows.…”

mentioning

confidence: 99%

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Trochlear nerve palsy and contralateral internuclear ophthalmoplegia: an unusual crossed syndrome

Borgman

2020

Clinical and Experimental Optometry

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Trochlear nerve palsy and contralateral internuclear ophthalmoplegia: an unusual crossed syndrome

Borgman

2020

Clinical and Experimental Optometry

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“…A highly unusual syndrome involves a unilateral lesion of the MLF at the level of the caudal midbrain with extension into the trochlear nucleus on the same side. 30 This lesion produces an INO and contralateral hyperdeviation secondary to a IV nerve palsy (remember the trochlear nerve exits and decussates to innervate the opposite side superior oblique muscle). This syndrome can be confused with a Volitional saccadic pathway with a lesion in the right medial longitudinal fasciculus (MLF) that results in an internuclear ophthalmoparesis (INO)…”

Section: Ino؉ Syndromes One-and-a-half Syndromementioning

confidence: 99%

Pearls & Oy-sters: The medial longitudinal fasciculus in ocular motor physiology

Frohman¹,

Galetta²,

Fox³

et al. 2008

Neurology

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“…When a skew deviation accompanies an INO, the hyperdeviated eye is on the side of the lesion in the MLF. 1,17,33,55…”

Section: Skew Deviationmentioning

confidence: 99%

Vertical Diplopia

Acierno¹

2000

Semin Neurol

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The diagnosis of an acquired vertical strabismus is not always straightforward. There is no one specific test that will diagnose a vertical deviation. The clinical presentation, signs, and symptoms are the driving forces that will help lead to the correct diagnosis. Patients with binocular vertical diplopia may have symptoms of recent onset or that have been long-standing. Others may not even be completely aware that their ocular symptoms are attributable to a doubled vertical image. The differential diagnosis for vertical diplopia includes oculomotor nerve palsy, superior oblique palsy, restrictive ophthalmopathies, myasthenia gravis, and skew deviation. This differential diagnosis is best used to sort out signs and symptoms in a patient with a vertical misalignment and diplopia. Because most clinicians feel more comfortable addressing the patient with complaints of horizontal diplopia, this paper will discuss the causes of vertical diplopia so that recognition will be easier, thus leading to more accurate diagnoses.

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Combined Trochlear Nerve Palsy and Internuclear Ophthalmoplegia

Cited by 36 publications

References 5 publications

Trochlear nerve palsy and contralateral internuclear ophthalmoplegia: an unusual crossed syndrome

Trochlear nerve palsy and contralateral internuclear ophthalmoplegia: an unusual crossed syndrome

Pearls & Oy-sters: The medial longitudinal fasciculus in ocular motor physiology

Vertical Diplopia

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