Wall-Eyed bilateral internuclear ophthalmoplegia: Case report and anatomy review
"Bilateral internuclear ophthalmoplegia associated with bilateral exotropia, also referred to as Wall-Eyed Bilateral Internuclear Ophthalmoplegia (WEBINO), is a rare neuro-ophthalmological syndrome characterized by limitation in bilateral eye adduction, bilateral exotropia, and nystagmus upon a...
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| Published in: | Medical Reports Vol. 3; p. 100035 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Elsevier Ltd
01-02-2024
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | "Bilateral internuclear ophthalmoplegia associated with bilateral exotropia, also referred to as Wall-Eyed Bilateral Internuclear Ophthalmoplegia (WEBINO), is a rare neuro-ophthalmological syndrome characterized by limitation in bilateral eye adduction, bilateral exotropia, and nystagmus upon abduction. We present a case of a 79-year-old female patient with cardiovascular risk factors who presented with a sudden onset of headache, vertigo, and gait disturbance. Neurological examination revealed cognitive deficits, dysarthria, and neuro-ophthalmological manifestations including bilateral exotropia, abduction limitation, nystagmus, altered convergence, as well as dysmetria and dysdiadochokinesia. Magnetic resonance imaging (MRI) showed a mesencephalic infarction involving bilateral medial longitudinal fasciculus (MLF) due to an acute cerebrovascular attack (CVA). The uniqueness of this paper is based on the wide review of the anatomical structures involved in conjugate gaze and the neuroanatomical pathways responsible for activating the extraocular muscles, and the description of the central nervous system (CNS) involvement underlying WEBINO and its associated symptoms, along with an overview of its manifestations and management.” |
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| ISSN: | 2949-9186 |
| DOI: | 10.1016/j.hmedic.2023.100035 |