Internuclear Ophthalmoplegia as a Sole Presentation of Acute Ischemic Stroke Involving the Midbrain with an NIH Stroke Scale of One
Received Date: Nov 15, 2017 / Accepted Date: Nov 20, 2017 / Published Date: Nov 27, 2017
Abstract
The National Institute of Health Sciences Scale (NIHSS) is a popular screening tool in the Emergency Department to rule out strokes. However, a small number of cases can be missed. But it is useful to remember that any sudden onset cranial nerve involvement could be a symptom of stroke and hence must be investigated thoroughly as time is brain. Internuclear ophthalmoparesis (INO) or internuclear ophthalmoplegia is very typical of a brainstem lesion. Our patient had complaints of sudden onset diplopia secondary to internuclear ophthalmoplegia with no other signs or symptoms. Though her NIHSS was only 1, given her longstanding history of hypertension, an immediate CT Brain was ordered which showed a fresh infarct of the left Medial Longitudinal fasciculus.
Keywords: Stroke; Internuclear ophthalmoplegia; Diplopia; Medial longitudinal fasciculus; Emergency medicine
Citation: Shetty NU, Shpilko M (2017) Internuclear Ophthalmoplegia as a Sole Presentation of Acute Ischemic Stroke Involving the Midbrain with an NIH Stroke Scale of One. J Biol Med Sci 1: 104.
Copyright: © 2017 Shetty NU. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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