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Internuclear Ophthalmoplegia

The document discusses internuclear ophthalmoplegia which is caused by damage to the medial longitudinal fasciculus connecting the third and sixth nerve nuclei. It describes the components of a complete internuclear ophthalmoplegia and causes such as infarction, demyelination, or vasculitis. Bilateral cases are often due to multiple sclerosis.

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Iqra Asif
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31 views1 page

Internuclear Ophthalmoplegia

The document discusses internuclear ophthalmoplegia which is caused by damage to the medial longitudinal fasciculus connecting the third and sixth nerve nuclei. It describes the components of a complete internuclear ophthalmoplegia and causes such as infarction, demyelination, or vasculitis. Bilateral cases are often due to multiple sclerosis.

Uploaded by

Iqra Asif
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Internuclear ophthalmoplegia

The third and sixth nerve nuclei are connected by the medial longitudinal
fasciculus. The decussation is posterior close to the PPRF. Fibers that mediate accommodation are anterior (and
innervate the third nerve).
A complete internuclear ophthalmoplegia is illustrated (Fig. 3.9) to right
lateral gaze. The components are:
1 nystagmus of the abducting eye;
2 failure to cross the midline (or lag) of the adducting eye;
3 upbeat nystagmus;
4 failure to converge if the lesion is anterior (third nerve area).
If the failure of adduction is complete, the problem is usually an infarction
of a penetrating branch of the basilar artery. Less complete lesions are usually caused by demyelinating disease or a
vasculitic process. If convergence
is maintained, the lesion is posterior at the decussation of the MLF (one of
Cogan’s laws). The pupils are not involved.
A bilateral internuclear ophthalmoparesis is most often brought about
by multiple sclerosis, rarely by systemic lupus erythematosus. Pseudointernuclear ophthalmoparesis occurs with
myasthenia gravis, muscle
disease and pressure on the pons.

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