Diagnostic Agreement of Video Oculography and MRI for Internuclear Ophthalmoplegia in Multiple Sclerosis Patients

Internuclear ophthalmoplegia (INO) affects 20-30% of patients with multiple sclerosis (MS). There is no established gold-standard for diagnosing INO. Magnetic resonance imaging (MRI) is a widely used ancillary test for detecting lesions in the medial longitudinal fasciculus (MLF), yet not all patients with INO show such lesions. Early INO detection is important for disease subtyping, treatment and prognosis of MS. In one study(1), 71% of clinicians missed the diagnosis of subtle INO, that was otherwise detected using video oculography (VOG).