The clinical spectrum of internuclear ophthalmoplegia in multiple sclerosis
R. M. Muri and O. Meienberg
The eye movements of 100 patients with multiple sclerosis were examined
clinically, including a saccade test. Thirty-four cases of internuclear
ophthalmoplegia were found, of which 14 were bilateral and 20 were
unilateral. Only three patients had full restriction of adduction, whereas
16 had no restriction at all. A continuous dissociated nystagmus was
present in one patient only, while in 15 just a few beats of the abducting
eye could be observed. In ten cases both restriction of adduction and
dissociated nystagmus were lacking, and the diagnosis could only be made
with the saccade test, which in all 34 patients showed a clearly visible
disjunction of horizontal saccades. In 15 cases, infrared oculography was
performed, which in all cases confirmed the clinical findings, and which in
some cases disclosed an additional subclinical internuclear ophthalmoplegia
on the opposite side.
