Open AccessParamedian pons infarction with wall‐eye monocular internuclear ophthalmoplegia syndrome
Author(s) -
Chen YouChia,
Chan Lung,
Cho ShiauShan,
Chiou WeiTing,
Ko Tzushiang,
Hu ChaurJong
Publication year - 2016
Publication title -
the kaohsiung journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.439
H-Index - 36
eISSN - 2410-8650
pISSN - 1607-551X
DOI - 10.1016/j.kjms.2015.11.001
Subject(s) - medicine , internuclear ophthalmoplegia , medial longitudinal fasciculus , magnetic resonance imaging , infarction , hemifacial spasm , perforating arteries , paralysis , basilar artery , anatomy , radiology , surgery , cardiology , artery , facial nerve , midbrain , myocardial infarction , psychiatry , multiple sclerosis , central nervous system
Wall-eye monocular internuclear ophthalmoplegia (WEMINO) is a lacunar infarction syndrome presenting with transient hemi-seesaw nystagmus. We present a 47-year-old woman, who suffered from sudden onset of left hemifacial numbness, double vision, mild dysarthria, and unsteady gait after dinner. The first neurologic examination was performed about 16 hours after onset of symptoms. Right exotropia with adduction paralysis and hemi-seesaw nystagmus associated with left hemifacial paresthesia were noted. Romberg test was negative but obvious ataxic gait was noted during the first visit, and her dysarthria was resolved a few hours after the examination. Brain magnetic resonance imaging was performed 24 hours after onset of symptoms (Figures 1A and 1B), where an acute infarction in the right upper paramedian