Prognosis of ischemic internuclear ophthalmoplegia.
OBJECTIVE
To determine the prognosis of internuclear ophthalmoplegia (INO) caused by infarction.


METHODS
Multicenter, retrospective observational case series.


METHODS
Thirty three patients with ischemic-related INO.


METHODS
Chart review of clinical details.


METHODS
Resolution of diplopia in primary position.


RESULTS
Of the group, 78.8% demonstrated resolution of diplopia in primary position with an average time to resolution of 2.25 months. The presence of associated neurologic symptoms (vertigo, ataxia, dysarthria, facial palsy, pyramidal tract signs) correlated with a worse prognosis for resolution of diplopia. When performed magnetic resonance imaging (MRI) demonstrated the causative infarct in only 52% of cases; the presence of an MRI-demonstrable lesion was not significantly associated with prognosis for resolution.


CONCLUSIONS
Similar to ischemic ocular motor palsies, most ischemic-based INO become asymptomatic in primary position over 2 to 3 months. The presence of associated features correlated with persistent diplopia. MRI has limited yield in demonstrating the causative infarct.
Eggenberger
Eric
E
Michigan State University, Department of Neurology and Ophthalmology. East Lansing, Michigan 48824-1313, USA.
Golnik
Karl
K
Lee
Andrew
A
Santos
Ronel
R
Suntay
Analyn
A
Satana
Banu
B
Vaphlades
Michael
M
Stevens
Charles
C
Kaufman
David
D
Wall
Michael
M
Kardon
Randy
R
D000368:Aged; D002545:Brain Ischemia / Q000150:complications*; D002544:Cerebral Infarction / Q000150:complications; D004172:Diplopia / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000209:etiology* / Q000503:physiopathology; D011379:Prognosis; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D013997:Time Factors