Bilateral pseudo-internuclear ophthalmoplegia in myasthenia gravis

ORL; Journal for Oto-rhino-laryngology and Its Related Specialties
K ItoM Mizuno

Abstract

A 38-year-old male with bilateral pseudo-internuclear ophthalmoplegia (-INO) in myasthenia that could have been misdiagnosed as INO in multiple sclerosis is reported. He experienced fluctuating symptoms including double vision, imbalance, and tinnitus. His eye movements simulated bilateral INO, with a downshoot in abduction. After thymectomy, his eye movements became normal. From our case and a review of the literature, we propose that ptosis, downshoot, and fatigability are likely to be signs of pseudo-INO in myasthenia, whereas an impaired vertical smooth pursuit is unlikely. Dissociated nystagmus and monocular overshoot might be the results of central compensation.

Citations

Nov 29, 2001·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·F BandiniS Simonetti
Apr 28, 2009·Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus·Gemma E ArblasterIrene M Pepper
Jan 1, 2012·JRSM Cardiovascular Disease·Puneet KakarPaul Bentley

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