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  • Title: Reversible bilateral internuclear ophthalmoplegia following head injury.
    Author: Hsu HC, Chen HJ, Lu K, Liang CL.
    Journal: Acta Ophthalmol Scand; 2001 Feb; 79(1):57-9. PubMed ID: 11167289.
    Abstract:
    PURPOSE: Internuclear ophthalmoplegia is a syndrome produced by a lesion in the medial longitudinal fasciculus. Head trauma is a rare cause. We describe an unusual case of bilateral internuclear ophthalmoplegia as an isolated sequela following a minor head injury that resolved completely 3 months later. METHODS: Case report. Magnetic resonance images. RESULTS: A 34-year-old male developed typical bilateral internuclear ophthalmoplegia after closed head injury. Attempted convergence was normal. Magnetic resonance imaging clearly delineated the focal hemorrhage in the medial longitudinal fasciculus region by showing a small bright lesion in the pontomesencephalic junction in the midline on both T2-weighted and T1-weighted images. The diplopia resolved 4 weeks later. Three months after the accident, his versions were completely normal. CONCLUSION: Isolated internuclear ophthalmoplegia should be considered in the differential diagnosis when one encounters an adduction deficit in a recently traumatized patient. Magnetic resonance images enhance the ability to correlate the clinical findings with the anatomic lesion.
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