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Isolated medial longitudinal fasciculus syndrome due to small midbrain infarction
Author(s) -
Kobayashi Zen,
Iizuka Mihoko,
Tomimitsu Hiroyuki,
Shintani Shuzo
Publication year - 2014
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.97
Subject(s) - medial longitudinal fasciculus , medicine , diplopia , midbrain , internuclear ophthalmoplegia , nystagmus , neurological examination , tegmentum , anisocoria , lesion , anatomy , infarction , magnetic resonance imaging , ataxia , ophthalmology , surgery , radiology , cardiology , neuroscience , psychology , multiple sclerosis , pupil , central nervous system , psychiatry , myocardial infarction
Isolated medial longitudinal fasciculus ( MLF ) syndrome as a result of midbrain infarction is rare, and its magnetic resonance imaging ( MRI ) has not been reported previously. A 62‐year‐old man suddenly presented with diplopia, and consulted JA Toride Medical Center, Ibaraki, Japan. The patient complained of diplopia when viewing targets on the left side. Examination of the ocular movement showed only adduction disturbance of the right eye. There was no anisocoria, nystagmus, convergence disturbance, blepharoptosis, motor weakness, ataxia or sensory disturbance. Diffusion‐weighted brain MRI showed a small high‐intensity lesion in the right paramedian portion of the caudal midbrain tegmentum, which was thought to involve the right MLF . Re‐examination of the patient 18 days after onset showed the disappearance of the adduction disturbance of the right eye, and diffusion‐weighted MRI approximately 1 month after onset showed resolution of the high intensity lesion. This is the first report of isolated MLF syndrome in which midbrain infarction was confirmed with MRI .