Bilateral Internuclear Ophthalmoplegia as a Presenting Sign of Multiple Sclerosis: An Interdisciplinary Approach to Diagnosis and Management
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system with various neurological and ocular manifestations. Ocular involvement occurs in approximately 80% of patients sometime during the course of the illness, and may be the presenting sign in about 50% of the patients with this disease. Bilateral internuclear ophthalmoplegia (BINO) is a common ocular complication of MS, occurring in up to one third of all MS patients. BINO is an ocular motility impairment characterized by a total or partial inability to adduct each eye accompanied by a concomitant nystagmus of the abducting eye on lateral gaze and a vertical gaze-evoked nystagmus. The importance of using an interdisciplinary approach to properly diagnose and manage MS will be discussed with a case review of a 57 year-old patient with BINO.
Reynolds SA, Pizzimenti J, Woods AD. Bilateral Internuclear Ophthalmoplegia as a Presenting Sign of Multiple Sclerosis: An Interdisciplinary Approach to Diagnosis and Management. The Internet Journal of Allied Health Sciences and Practice. 2004 Jul 01;2(3), Article 2.