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Matthew Rizzo, MD; James Corbett, MD

Arch Neurol. 1983;40(4):242-243.

Abstract
• We encountered an apparent bilateral internuclear ophthalmoplegia (INO) in a stuporous patient who used narcotics and benzodiazepines and had taken phenytoin sodium for drug-withdrawal seizures. The INO was promptly reversed by administration of the narcotic antagonist naloxone, which binds opiate receptors. This suggests the INO resulted from a specific toxic effect of narcotics, but opiate receptors have not been anatomically demonstrated within the medial longitudinal fasciculus or associated structures. Stimulation of inhibitory GABA-ergic (-aminobutyric acid) vestibulo-ocular fibers may have been related to INO in this case.

Author Affiliations
From the Department of Neurology (Drs Rizzo and Corbett) and the Neuro-ophthalmology Unit (Dr Corbett), University of Iowa Hospitals and

Footnotes
Accepted for publication Sept 9, 1982.

Clinics, Iowa City.

Reprint requests to Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 (Dr Rizzo).

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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Bilateral Internuclear Ophthalmoplegia Reversed by Naloxone
Gillman and Sandyk
Arch Neurol 1984;41:703-703.
ABSTRACT