Internuclear ophthalmoplegia (INO) is a sign of exquisite localizing value, of ten due to either multiple sclerosis or infarction. To demonstrate that unusual causes of INO are more common than the 11%reported in prev...Internuclear ophthalmoplegia (INO) is a sign of exquisite localizing value, of ten due to either multiple sclerosis or infarction. To demonstrate that unusual causes of INO are more common than the 11%reported in previous series, this rev iew considers a case series of 410 inpatients whom I personally examined during a 33-year period. In this series, the cause of INO was infarction in 157 patien ts (38%), multiple sclerosis in 139 (34%), and unusual causes in 114 (28%). U nusual causes included trauma (20 cases), tentorial herniation (20 cases), infec tion (17 cases), tumor (17 cases), iatrogenic injury (12 cases), hemorrhage (13 cases), vasculitis (7 cases), and miscellaneous (8 cases). Internuclear ophthalm oplegia was unilateral in 136 of the infarct cases (87%), 38 of those with mult iple sclerosis (27%), and 48 of the unusual cases (42%). Because unusual cause s compose more than one quarter of the cases, the differential diagnosis of INO should be tripartite: multiple sclerosis, stroke, and other causes.展开更多
文摘Internuclear ophthalmoplegia (INO) is a sign of exquisite localizing value, of ten due to either multiple sclerosis or infarction. To demonstrate that unusual causes of INO are more common than the 11%reported in previous series, this rev iew considers a case series of 410 inpatients whom I personally examined during a 33-year period. In this series, the cause of INO was infarction in 157 patien ts (38%), multiple sclerosis in 139 (34%), and unusual causes in 114 (28%). U nusual causes included trauma (20 cases), tentorial herniation (20 cases), infec tion (17 cases), tumor (17 cases), iatrogenic injury (12 cases), hemorrhage (13 cases), vasculitis (7 cases), and miscellaneous (8 cases). Internuclear ophthalm oplegia was unilateral in 136 of the infarct cases (87%), 38 of those with mult iple sclerosis (27%), and 48 of the unusual cases (42%). Because unusual cause s compose more than one quarter of the cases, the differential diagnosis of INO should be tripartite: multiple sclerosis, stroke, and other causes.
