II. Pathophysiology
-
Medial Longitudinal Fasciculus (MLF) - normal function
- MLF is a myelinated pathway through the tegmentum of the Midbrain and dorsal pons
- On lateral gaze, Cranial Nerve 6 abducts the ipsilateral eye
- To maintain Conjugate Gaze, a signal is passed via MLF to the contralateral eye's CN 3 to adduct (medially) in parallel
- With a MLF lesion, the adducting eye via CN 3 fails to adduct
- Bilateral MLF lesion results in a Wall-eyed appearance
- Bilateral adduction deficits result in Exotropia
-
Extraocular Movement is normal in other directions
- Primary gaze remains parallel
- Eye convergence on near Vision remains intact
III. Causes
- Older adults (esp. unilateral involvement)
- Vascular disease affecting the vertebrobasilar circulation
- Young adults (esp. bilateral involvement)
- Children
- Pontine glioma (MRI)
- Vasculitis may also cause Internuclear Ophthalmoplegia in this age group
- Alcoholism
IV. References
- Berson (1990) Ophthalmology Study Guide, AAO, p. 116-7
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Related Studies
Concepts | Disease or Syndrome (T047) |
MSH | D015835 |
ICD9 | 378.86 |
ICD10 | H51.2 |
SnomedCT | 49823009 |
English | INO - Internucl ophthalmopleg, Ophthalmoplegia, Internuclear, Internuclear Ophthalmoplegias, Ophthalmoplegias, Internuclear, Internucl ophthalmopleg, lhermitte's syndrome, internuclear ophthalmoplegia, Internuclear ophthalmoplegia, Ophthalmoplegia internuclearis, Lhermitte's syndrome, Bielschowsky-Lutz-Cogan syndrome, INO - Internuclear ophthalmoplegia, Internuclear ophthalmoplegia (disorder), internuclear; ophthalmoplegia, ophthalmoplegia; internuclear, Internuclear Ophthalmoplegia |
Dutch | internucleaire oftalmoplegie, internucleair; oftalmoplegie, oftalmoplegie; internucleair, Internucleaire oftalmoplegie, Oftalmoplegie, internucleaire |
French | Ophthalmoplégie internucléaire, Ophtalmoplégie internucléaire |
German | internukleaere Ophthalmoplegie, Internukleäre Ophthalmoplegie, Internukleaere Ophthalmoplegie |
Portuguese | Oftalmoplegia internuclear, Oftalmoplegia Internuclear |
Spanish | Oftalmoplejía internuclear, Oftalmoplejía Internuclear, oftalmoplejía internuclear (trastorno), oftalmoplejía internuclear, síndrome de Bielschowsky - Lutz - Cogan, síndrome de Lhermitte |
Japanese | 核間性麻痺, カクカンセイマヒ |
Czech | Internukleární oftalmoplegie, internukleární oftalmoplegie |
Korean | 핵간 안근마비 |
Hungarian | Internuclearis ophtamoplegia |
Norwegian | Internukleær oftalmoplegi |
Italian | Oftalmoplegia internucleare |
Ontology: Palsy of conjugate gaze (C0702143)
Concepts | Disease or Syndrome (T047) |
ICD9 | 378.81 |
ICD10 | H51.0 |
SnomedCT | 193169002, 194130001, 1534008 |
Dutch | geconjugeerde oogspierverlamming, geconjugeerd; blikparalyse, Verlamming van geconjugeerde blik |
French | Paralysie avec déviation conjuguée des yeux |
German | konjugierte Blicklaehmung, Konjugierte Blicklaehmung |
Italian | Paralisi dello sguardo coniugato |
Portuguese | Perturbação dos movimentos oculares coordenados |
Spanish | Parálisis de la mirada conjugada, parálisis de la mirada conjugada (trastorno), parálisis de la mirada conjugada |
Japanese | 共同注視麻痺, キョウドウチュウシマヒ |
English | conjugate gaze palsy, conjugate gaze palsy (diagnosis), Conjugate gaze palsy (disorder), Palsy of conjugate gaze, Conjugate gaze palsy, Palsy of conjugate gaze (disorder), conjugate; gaze, palsy, Conjugate gaze palsy [Ambiguous] |
Czech | Obrna konjugovaného pohledu |
Korean | 공동주시 마비 |
Hungarian | Konjugált tekintés bénulás |
Ontology: Medial longitudinal fasciculus syndrome (C1963860)
Concepts | Disease or Syndrome (T047) |
English | Medial longitudinal fasciculus syndrome |
Spanish | Síndrome del fascículo longitudinal medial |
French | Syndrome du faisceau longitudinal médian |
Dutch | Medial Longitudinal Fasciculus-syndroom |
Portuguese | Síndrome do fascículo longitudinal medial |
German | Faszikulus longitudinalis medialis-Syndrom |
Italian | Sindrome del fascicolo longitudinale-mediale |
Japanese | 内側縦束症候群, ナイソクジュウソクショウコウグン |
Czech | Syndrom mediálního longitudinálního fascikulu |
Hungarian | Medialis longitudinalis köteg syndroma |