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name the two forms of internuclear opthalamoplegia
Internuclear opthalmoplegia
Lesion between III and IV nuclei
bilateral often due to MS, unilateral often vascular
Patient often has diplopia - double vision
Unilateral - disrupt the adducting saccades on ipsilateral side, convergence is preserved as those fibres don’t pass through the MLF
Presence of convergence shows that the nerves and nuclei are intact and lesion in MLF
One and a half syndrome
Leison in MLF and abducens nucleus
Causes - MS,pontine stroke or tumour
One and a half syndrome - lesion invloves MLF and ispliateral abducens nerve
Saccades for adduction and abduction lost in ipsilateral eye and adductiing saccades lost in contralateral eye.
One and a half syndrome as all horizontal saccades lost form one eye and half of them from the other
Lesion between III and IV nuclei
bilateral often due to MS, unilateral often vascular
Patient often has diplopia - double vision
Unilateral - disrupt the adducting saccades on ipsilateral side, convergence is preserved as those fibres don’t pass through the MLF
Presence of convergence shows that the nerves and nuclei are intact and lesion in MLF
One and a half syndrome
Leison in MLF and abducens nucleus
Causes - MS,pontine stroke or tumour
One and a half syndrome - lesion invloves MLF and ispliateral abducens nerve
Saccades for adduction and abduction lost in ipsilateral eye and adductiing saccades lost in contralateral eye.
One and a half syndrome as all horizontal saccades lost form one eye and half of them from the other
