Neurological Sciences

, Volume 39, Issue 4, pp 795–796 | Cite as

Isolated bilateral internuclear ophthalmoplegia due to lacunar infarction

  • Zhao Jiang
  • Wenhong Wang
Letter to the Editor

Dear Editor:

Isolated bilateral internuclear ophthalmoplegia (INO) due to brainstem lacunar infarction is clinically rare [1]. Here, we report a case of isolated bilateral INO accompanied by convergence reflex disorder. Cranial magnetic resonance imaging (MRI) showed that our patient had an acute lacunar infarction next to the midline of the bilateral pontine tegmentum.

A 73-year-old woman was admitted for sudden dizziness with diplopia, which she had experienced for 1 day. She had a history of hypertension lasting more than 10 years. Neurological examination showed that, when both eyes were turned to one side, ipsilateral ocular abduction was accompanied by horizontal nystagmus, and contralateral ocular adduction could not pass the midline (Fig.  1). Primary gaze and up or down gaze were normal, but the convergence reflex was impaired. Remaining neurological examinations showed no abnormality. After the patient was admitted, emergency cranial MRI was carried out and showed a high...



No financial or material support was provided for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of NeurologyTianjin First Center HospitalTianjinChina

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