WEBINO (wall-eyed bilateral internuclear ophthalmoplegia) syndrome is a rare clinical syndrome of exotropia with bilateral INO associated with the loss of fusional vergence.
Previously reported in only 2 patients with progressive supranuclear palsy (PSP)
Aetiology
It is usually caused by demyelination or ischaemic damage to the medial longitudinal fasciculus and medial rectus subnucleus of the oculomotor nerve
Clinical features
Wall-eyed gaze impairment (bilateral adduction impairment)Nystagmus of the abducting eyePrimary gaze exotropia
Neuro-ophthalmologic examination: (A) Ocular motility. (B) Brain MRI: diffusion-weighted images (left panel) and apparent diffusion coefficient images (right panel) reveal a focal ischemic stroke located in the dorsal pons (arrows). | Mathis, T., Ducray, F., Tilikete, C., Vighetto, A., & Biotti, D. (2014). Pontine infarction responsible for wall-eyed bilateral internuclear ophthalmoplegia syndrome. Neurology. Clinical practice, 4(6), 524–525. https://doi.org/10.1212/CPJ.0000000000000063
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