Search results for "Internuclear ophthalmoplegia"
showing 9 items of 9 documents
Abduction saccades in unilateral internuclear ophthalmoplegia
1990
Horizontal eye movements were investigated in 60 consecutive patients with unilateral internuclear ophthalmoplegia utilizing direct current electrooculography. In nine patients additional conjugated slowing of ipsiversive saccades indicated the diagnosis of a one-and-a-half syndrome. Slowing of abduction saccades was bilateral in two patients and unilateral in 20 (ipsilateral to the MLF lesion in 17 patients and contralateral in three). Slowing of abduction saccades was attributed to impaired inhibition of the tonic resting activity of the antagonistic medial rectus muscle. On the eye contralateral to the lesion 70% of the patients had abduction nystagmus and 66.7% hy permetric abduction sa…
Slowed abduction saccades in bilateral internuclear ophthalmoplegia
1992
Horizontal eye movements were investigated in 65 patients with bilateral internuclear ophthalmoplegia utilizing direct current electro-oculography. Abduction saccades were slowed in 35 patients (53.8%), being hypermetric in 65.7% of them. Slowing of abduction saccades is attributed to impaired inhibition of the tonic resting activity of the antagonistic medial rectus muscle. Experimental data indicate that this slowing results from a lesion of an uncrossed connection between the pontine reticular formation and the oculomotor nucleus. The prevalence of hypermetric abduction saccades increased with increasing severity of adduction paresis on the opposite eye. This confirms the view that media…
The Internuclear Ophthalmoplegias
1993
Internuclear ophthalmoplegia (INO), which is caused by an ipsilateral medial longitudinal fasciculus (MLF) lesion, is characterized by adduction paresis of lateral gaze, usually with spared convergence [1–4]. In the opposite eye, abduction nystagmus and hypermetric abduction saccades are the main clinical and electro-oculographic abnormalities [1, 5, 6]. The origin of both is still debated. Abduction nystagmus has been explained by (a) an additional horizontal gaze paresis [7]; (b) vergence mechanisms aimed at alignment of the visual axes [8]; (c) interruption of descending excitatory projections from oculomotor nucleus internuclear neurons to contralateral abducens nucleus motoneurons [9];…
Midbrain vs. pontine medial longitudinal fasciculus lesions: The utilization of masseter and blink reflexes
1991
Masseter (MR) and blink reflexes (BL) were investigated in 51 patients with internuclear ophthalmoplegia (INO) due to multiple sclerosis (28) and lacunar infarction (23). The MR was abnormal in 20 of 23 cases with bilateral INO and in 21 of 28 with unilateral INO. The R1 component of the BL (BL-R1) was abnormal in 7 of 23 patients with bilateral INO and 10 of 28 with unilateral INO. Combined MR and BL-R1 changes occurred in 8 of 28 cases with unilateral INO and 7 of 23 with bilateral INO. The findings provide evidence for a rostral/caudal localization of lesions within the medial longitudinal fasciculus causing INO on the basis of MR and BL-R1 abnormalities. An abnormality limited to MR sug…
A new method to investigate brain stem structural-functional correlations using digital post-processing MRI - reliability in ischemic internuclear op…
2001
We investigated the reliability of a new digital post-processing magnetic resonance imaging (MRI) technique in ischemic brain stem lesions to identify relations of the lesion to anatomical brain stem structures. The target was a medial longitudinal fasciculus (MLF) lesion, which was evident from ipsilateral internuclear ophthalmoplegia (INO). Sixteen patients with acute unilateral INO and an isolated acute brain stem lesion in T2- and EPI-diffusion weighted MRI within 2 days after the onset of symptoms were studied. The MRI slice direction was parallel and perpendicular to a slice selection of a stereotactic anatomical atlas. The individual slices were normalized and projected in the digita…
Abduction nystagmus in internuclear ophthalmoplegia
1992
Direct current electro-oculography revealed abduction nystagmus with hypermetric abduction saccades in 35 of 64 patients with unilateral and 55 of 66 patients with bilateral internuclear ophthalmoplegia. Slowing of abduction saccades occurred in 27 unilateral cases, mainly ipsilateral to the paretic eye, and in 36 bilateral cases. Abduction nystagmus with hypermetric abduction saccades of normal velocity is explained by an increased phasic innervation adjusted to adduction paresis. Slowed abduction saccades are attributed to impaired inhibition of the medial rectus muscle. Superposition of impaired medial rectus inhibition and increased phasic innervation best explains abduction nystagmus w…
Diagnostic Localizing Value of the Electrically Elicited Blink Reflex
1993
The blink reflex (BlinkR) following electrical stimulation of the supraorbital nerve consists of an early ipsilateral reflex component (R1) and bilateral late reflex components ipsilaterally (R2) and contralateral (R2c). An additional, and even later component, also bilateral, R3, R3c was first described by Penders and Delwaide [34] and so far has not been studied systematically.
Internuclear ophthalmoplegia of abduction: clinical and electrophysiological data on the existence of an abduction paresis of prenuclear origin.
1992
Three patients showed unilateral and five bilateral abduction paresis. Five had associated adduction nystagmus of the contralateral eye. Electrophysiological testing of masseter and blink reflexes indicated an ipsilateral rostral pontine or mesencephalic lesion, and excluded a lesion of the infranuclear portion of the abducens nerve. Abduction paresis was attributed to impaired inhibition of the tonic resting activity of the antagonistic medial rectus muscle. The prenuclear origin of the disorder is based on morphological and neurophysiological evidence of an ipsilateral inhibitory connection between the paramedian pontine reticular formation and the oculomotor nucleus running close to but …
Binocular, Accommodative and Oculomotor Alterations In Multiple Sclerosis: A Review
2020
Multiple sclerosis (MS) is an acquired demyelinating and inflammatory neurodegenerative disease affecting the central nervous system (CNS). Clinical and subclinical ocular disturbances occur in almost all patients with MS. The objective of this narrative review was to collect and summarize the available scientific information on oculomotor, accommodative and binocular alterations that have been reported in MS. A systematic search strategy with the following descriptors was carried out: multiple sclerosis, ocular motility disorders, internuclear ophthalmoplegia, nystagmus, vergences, fixation, pupil reflex, accommodation and stereopsis. According to the search, some oculomotor alterations w…