Pure isolated unilateral internuclear ophthalmoplegia from ischemic origin: report of a case and literature review.

PURPOSE: To report a case of pure isolated unilateral internuclear ophthalmoplegia from ischemic stroke, and to review its literature.

METHODS

A 55-year old man, with a history of long-standing diabetes mellitus, developed acute-onset left internuclear ophthalmoplegia. MRI revealed a small paramedian dorsal pontine infarct ventral and lateral to the aquaductus cerebri. Intracranial MR angiography was normal. A systematic search was performed of the literature from January 1980 to December 2004 by using MEDLINE and EMBASE. Case reports with or series including patients with negative MRI findings were excluded.

RESULTS

Nine cases of pure isolated MRI-proven unilateral INO resulting from ischemic stroke including this one, have been reported. In over 75% recovery was reported.

CONCLUSION

Isolated unilateral internuclear ophthalmoplegia can be the sole manifestation of ischemic stroke and generally carries a good prognosis.