Bilateral internuclear ophthalmoplegia reversed by naloxone.
We encountered an apparent bilateral internuclear ophthalmoplegia (INO) in a stuporous patient who used narcotics and benzodiazepines and had taken phenytoin sodium for drug-withdrawal seizures. The INO was promptly reversed by administration of the narcotic antagonist naloxone, which binds opiate receptors. This suggests the INO resulted from a specific toxic effect of narcotics, but opiate receptors have not been anatomically demonstrated within the medial longitudinal fasciculus or associated structures. Stimulation of inhibitory GABA-ergic (alpha-aminobutyric acid) vestibulo-ocular fibers may have been related to INO in this case.
D000328:Adult; D005131:Eye Injuries / Q000150:complications; D006801:Humans; D008297:Male; D009270:Naloxone / Q000627:therapeutic use*; D009294:Narcotics; D009886:Ophthalmoplegia / Q000188:drug therapy* / Q000209:etiology; D019966:Substance-Related Disorders / Q000150:complications
D009294:Narcotics; D009270:Naloxone