Bilateral INOs Due to Stroke

Update item information
Identifier Bilateral_INOs_due_to_stroke
Title Bilateral INOs Due to Stroke
Subject Abnormal Saccades; Abnormal Range
Creator Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine
Description This is a 65-year-old man with multiple vascular risk factors who experienced the abrupt onset of diplopia 6 months prior to this video. MRI done within 24 hours of onset was unremarkable. Examination demonstrated subtle bilateral adduction lag with horizontal saccades. There was very mild abducting nystagmus to the right and left (not seen well in this video), also supportive of bilateral internuclear ophthalmoplegia (INO) in conjunction with the adduction lag. Despite the ‘normal' MRI, the etiology was felt to be ischemia (with false negative MRI) involving bilateral medial longitudinal fasciculi given his vascular risk factors and abrupt onset of improving symptoms. The diplopia resolved over months although a sensation of "visual lag" persisted when looking quickly to the right or to the left. This symptom was well explained by his adduction lag with horizontal saccades.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2020-04
Type Image/MovingImage
Format video/mp4
Relation is Part of NOVEL: Neuro-ophthalmology Virtual Education Library Examination Collection
Rights Management Copyright 2020. For further information regarding the rights to this collection, please visit:
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E, SLC, UT 84112-5890
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s62g2x71
Setname ehsl_novel_gold
Date Created 2020-04-13
Date Modified 2021-06-29
ID 1539412
Reference URL
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