Herpes zoster induced internuclear ophthalmoplegia a rare case report

Abstract

AbstractInternuclear ophthalmoplegia
(INO) is caused by lesion involving the
medial longitudinal fasciculus. Patients
with INO are usually asymptomatic but
they may complain of diplopia and occasionally
oscillopsia. The most common
causes of INO are ischemia and demyelination.
Various infectious etiologies such
as tuberculosis, AIDS, brucellosis, cysticercosis
and syphilis may produce INO.
Herpes zoster producing INO is a very
rare presentation. The possible pathogenic
mechanism could be demyelination
or microinfarction in the brainstem. Our
patient presented with a recent history of
herpes zoster followed by double vision.
On examination, he had right internuclear
ophthalmoplegia. Varicella zoster
IgM antibody was positive and he recovered
fully after treatment with Acyclovir
and steroids.