Research in Vestibular Science

Rapidly Progressive Ophthalmoplegia and Brainstem-Cerebellar Dysfunction in Rhombencephalitis Caused by Listeria monocytogenes: Sung-Sik Kim, Jong-Hun Kim, Jin-Heui Lee, Seung-Han Lee; Res Vestib Sci. 2017;16(1):29-33. Published online March 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.1.29

Abstract PDF: Listeria monocytogenes (L. monocytogenes) is a rare, but important bacterial pathogen causing central nervous system infection in the elderly, pregnant women, and immunocompromised patients. A 60-year-old man with diabetes presented with headache, fever and rapidly progressive ophthalmoplegia. Based on serological and MRI studies, he was diagnosed with rhombencephalitis due to L. monocytogenes. The patient recovered without complications with urgent initiation of empirical antibiotics and the pathogen-specific antibiotic treatment. L. monocytogenes should be considered as a cause of rhombencephalitis presenting as external ophthalmoplegia.

Upbeat Nystagmus in Association with Wall-Eyed Bilateral Internuclear Ophthalmoplegia: Duck Su Park, Yeo Jeong Kang, Tae Kyeong Lee, Kwang Ik Yang; Res Vestib Sci. 2014;13(1):24-27.

Abstract: A 54-year-old man presented with primary position upbeat nystagmus and wall-eyed bilateral internuclear ophthalmoplegia. He also showed bilateral limb ataxia and impaired horizontal gaze. Upbeat nystagmus obeyed Alexander’s law and attenuated by visual fixation and disappeared by convergence. Brain magnetic resonance imaging showed acute infarction in the bilateral paramedian midbrain involving the crossing of brachium conjunctivum. Multiple mechanisms including the interruption of central vestibulo-ocular projections from anterior canal may be postulated in upbeat nystagmus of this patient.

Bilateral Internuclear Ophthalmoplegia Following Spontaneous Subarachnoid Hemorrhage: Se Jin Oh, Kwang Dong Choi, Dae Soo Jung; J Korean Bal Soc. 2008;7(2):204-206.

Abstract PDF: A 44-year-old woman presented with horizontal diplopia 2 days after spontaneous subarachnoid hemorrhage. Neurological examination disclosed bilateral internuclear ophthalmoplegia and neck stiffness. Neurovascular imagings documented subarachnoid and intraventriclar hemorrhage with an aneurysm arising from the left superior cerebellar artery, and vasogenic edema in the bilateral pontomesencephalic junction. Parenchymal vasogenic edema due to microvascular damage may give rise to bilateral internuclear ophthalmoplegia during the acute stage of spontaneous subarachnoid hemorrhage. Key words: Bilateral internuclear ophthalmoplegia, Spontaneous subarachnoid hemorrhage, Vasogenic edema

Specific MRI and MRA findings of Dural Carotid Cavernous Sinus Fistula -A Case Report-: Won Hee Chung, Jong Se Lee, Tae Kyeong Lee, Ki Bum Sung; J Korean Bal Soc. 2006;5(2):296-298.

Abstract PDF: Dural carotid-cavernous sinus fistula (d-CCF) is a rare cause of ophthalmoplegia, and it may be overlooked when the prominent external orbito-ocular sign is lacking. Conventional angiography is the gold standard in the diagnosis of d-CCF. Recently, the specific MR findings of d-CCF have increasingly been reported. We report a patient with spontaneous d-CCF presenting with an isolated fourth-nerve palsy in whom magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) demonstrated d-CCF. Key Words : Carotid cavernous sinus fistula, Ophthalmoplegia, Angiography, Magnetic resonance imaging, Magnetic resonance angiography

Jerky Seesaw Nystagmus in Isolated Internuclear Ophthalmoplegia: Kyungmi Oh, Jae Hong Chang, Kun Woo Park, Dae Hie Lee, Kwang Dong Choi, Ji Soo Kim; J Korean Bal Soc. 2005;4(1):49-52.

Abstract PDF: The authors report jerky seesaw nystagmus, extorsional downbeating in the right eye and intorsional upbeating in the left eye, in a patient with right internuclear ophthalmoplegia (INO). This pattern of nystagmus may occur by disrupting pathways from contralateral posterior and anterior semicircular canals by a lesion in the medial longitudinal fasciculus. Depending on damage to the pathways from contralateral vertical canals, various patterns of dissociated torsional-vertical nystagmus may accompany INO.

Possible Mechanism of Seesaw Nystagmus in Internuclear Ophthalmoplegia: Ji Soo Kim, Kwang Dong Choi, Ja Won Koo, Kyungmi Oh, Jae Hong Chang, Kun Woo Park, Dae Hie Lee, Gyu Cheol Han; J Korean Bal Soc. 2004;3(2):413-416.

Abstract PDF: The authors report jerky seesaw nystagmus, extorsional downbeating in the ipsilesional eye and intorsional upbeating in the contralesional eye, in a patient with internuclear ophthalmoplegia (INO) from focal pontine lesion. This pattern of nystagmus may occur by disrupting pathways from contralateral posterior and anterior semicircular canals by a lesion in the medial longitudinal fasciculus. Depending on the pathways involved, various patterns of dissociated torsional-vertical nystagmus may accompany INO.

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