Bilateral Internuclear Ophthalmoplegia in Neuromyelitis Optica Spectrum Disorder

Neuromyelitis Optica (NMO) and NMO spectrum disorders are increasingly recognized clinical entities. Outside of typical cases, the physician must use clinical clues to determine whether it is appropriate to evaluate for NMO. Recent studies show that some NMO brain lesions tend to be located in the hypothalamus and around the third and fourth ventricles. This distinctive localization provides an opportunity to assist in the diagnosis of NMO, as is seen in the case we present here.