J Clin Neurol.  2018 Oct;14(4):574-576. 10.3988/jcn.2018.14.4.574.

Determining the Etiology of Internuclear Ophthalmoplegia in a Patient with a Cardiac Pacemaker and Complex Neurological Presentation

• Nourbakhsh B
• Cordano C
• Renthal W

• KMID: 2424188
• DOI: http://doi.org/10.3988/jcn.2018.14.4.574

Abstract

No abstract available.

MeSH Terms

Humans
Ocular Motility Disorders*

Figure

• 

  Fig. 1 Brain MRI of our patient with a pacemaker who presented with bilateral internuclear ophthalmoplegia. FLAIR sequences are shown. Arrows indicate lesion. A and B: Consecutive axial views through the pons revealing bilateral T2 hyperintensities within the posterior pons that involve both medial longitudinal fasciculi. C: Sagittal view through the brainstem. The demyelinating lesion extends approximately 7 mm. D: Sagittal view demonstrating multiple periventricular T2 hyperintensities consistent with demyelination. E: Axial FLAIR image showing several periventricular lesions.

Reference

1. Karatas M. Internuclear and supranuclear disorders of eye movements: clinical features and causes. Eur J Neurol. 2009; 16:1265–1277.

2. Bolaños I, Lozano D, Cantú C. Internuclear ophthalmoplegia: causes and long-term follow-up in 65 patients. Acta Neurol Scand. 2004; 110:161–165.

3. Keane JR. Internuclear ophthalmoplegia: unusual causes in 114 of 410 patients. Arch Neurol. 2005; 62:714–717.

4. Cronin EM, Mahon N, Wilkoff BL. MRI in patients with cardiac implantable electronic devices. Expert Rev Med Devices. 2012; 9:139–146.

5. Korutz AW, Obajuluwa A, Lester MS, McComb EN, Hijaz TA, Collins JD, et al. Pacemakers in MRI for the neuroradiologist. AJNR Am J Neuroradiol. 2017; 38:2222–2230.

6. Padmanabhan D, Jondal ML, Hodge DO, Mehta RA, Acker NG, Dalzell CM, et al. Mortality after magnetic resonance imaging of the brain in patients with cardiovascular implantable devices. Circ Arrhythm Electrophysiol. 2018; 11:e005480.

7. Ono M, Suzuki M, Isobe M. Feasibility, safety, and potential demand of emergent brain magnetic resonance imaging of patients with cardiac implantable electronic devices. J Arrhythm. 2017; 33:455–458.

8. Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018; 17:162–173.