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Internuclear Ophthalmoplegia in Childhood

Internuclear Ophthalmoplegia in Childhood. Shirley H. Wray, M.D., Ph.D. Professor of Neurology, Harvard Medical School Director, Unit for Neurovisual Disorders Massachusetts General Hospital. Figure 1A: Primary gaze. B: Gaze Right. Left internuclear ophthalmoplegia.

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Internuclear Ophthalmoplegia in Childhood

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  1. Internuclear Ophthalmoplegia in Childhood Shirley H. Wray, M.D., Ph.D. Professor of Neurology, Harvard Medical School Director, Unit for Neurovisual Disorders Massachusetts General Hospital

  2. Figure 1A: Primary gaze.

  3. B: Gaze Right. Left internuclear ophthalmoplegia

  4. C: Gaze left. Right internuclear ophthalmoplegia.

  5. Figure 2: Pneumoencephalography: blockage of the aqueduct.

  6. Figure 3: Pneumoencephalography: obstructive hydrocephalus. Enlarged ventricles.

  7. Figure 4: Enlarged ventricles, obstructive hydrocephalus.

  8. Figure 5: Histological section: Medulloblastoma.

  9. Bilateral Internuclear Ophthalmoplegia in Children A manifestation of Brain Stem Tumor 6 cases – 3 boys, 3 girls Ages 4.5, 7.5, 9.5, 10, 16, and 17 years Duration of symptoms: 9 mos. – 6 years (4/6 dead) Other Symptoms: Headache 4 Papilledema 1 Clumsiness 4 Pathology Medulloblastoma 1 Medulloblastoma or Glioma 2 Infiltrating Glioma 1 Cogan DG, Wray SH. Neurology. 1970. 20: 629 – 633.

  10. References Cogan DG, Kubik CS, Smith JL. Unilateral internuclear ophthalmoplegia: report of 8 clinical cases with 1 post-mortem study. Arch Ophthalmol 1950; 44:783-796. Cogan DG, Wray SH. Internuclear ophthalmoplegia as an early sign of brainstem tumor. Neurology 1970; 20:629-633.

  11. Cogan DG. Internuclear opthalmoplegia typical and atypical. Arch Ophthalmol 1970; 84:583-589. Keane JR. Internuclear ophthalmoplegia: unusual causes in 114 of 410 patients. Arch Neurol. 2005 May; 62(5):714-7.

  12. http://www.library.med.utah.edu/NOVEL

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