Objectives: To describe and review internuclear ophthalmoplegia (INO) in systemic lupus erythematosus (SLE). Patients and methods: A population of 268 SLE patients was retrospectively studied. INO was clinically defined as palsy of the ipsilateral rectus muscle and failure in contralateral eye adduction with dissociated nystagmus.
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The presence of INO (unilateral or bilateral) was determined by visual examination of the graphs depicting horizontal gaze position by two experienced observers (JANB, KMSK). The inter-rater agreement was 95.8% (23/24). The one patient in whom there was a disagreement had an INO of abduction and was excluded from this trial.
The diagnosis of INO can now be precisely confirmed neurophysiologically by a number of eye movement tracking techniques, such as infrared oculography. 18-24 These techniques can identify a variety of abnormalities in patients with INO including slowing of adduction saccades, abduction nystagmus, and diminished adduction saccadic amplitude .
A lesion in the medial longitudinal fasciculus (MLF) causes internuclear ophthalmoplegia (INO). Many intracranial lesions, such as multiple sclerosis or vascular disorders may be associated with INO; however, INO is a rare complication of minor head injury. The mechanism underlying injury to the MLF may be shear force on the brain stem during
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