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Bilateral internuclear ophthalmoplegia associated with pediatric brain tumor progression: a case series and review of the literature

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Abstract

Internuclear ophthalmoplegia (INO) is a rare disorder of conjugate lateral gaze that has been described in a number of neurologic conditions including multiple sclerosis, stroke and less commonly brain tumors. We describe a series of 3 boys (11, 12, 15 years) diagnosed with primary central nervous system tumors (pilomyxoid variant astrocytoma, anaplastic oligoastrocytoma, gliomatosis cerebri) who developed bilateral INO as a manifestation of progressive disease. Time from diagnosis to development of bilateral INO ranged from 13–36 months. All children died of their disease 1–9 months following diagnosis of bilateral INO and had significant dorsal pontine invasion on magnetic resonance imaging at progression. Only one child had brainstem involvement at diagnosis. Our case series highlights this rare ophthalmologic syndrome of bilateral INO in association with tumor progression and provides a literature review of brain tumor associations with INO.

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References

  1. Dolecek TA, Propp JM, Stroup NE, Kruchko C (2012) CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005–2009. Neuro-Oncol 14(suppl 5):v1–v49

    Article  PubMed  Google Scholar 

  2. Wilne S, Collier J, Kennedy C et al (2007) Presentation of childhood CNS tumours: a systematic review and meta-analysis. Lancet Oncol 8:685–695

    Article  PubMed  Google Scholar 

  3. Steinlin MI, Blaser SI, MacGregor DL, Buncic JR (1995) Eye problems in children with multiple sclerosis. Pediatr Neurol 12:207–212

    Article  PubMed  CAS  Google Scholar 

  4. Bolanos I, Lozano D, Cantu C (2004) Internuclear ophthalmoplegia: causes and long-term follow up in 65 patients. Acta Neurol Scand 110:161–165

    Article  PubMed  CAS  Google Scholar 

  5. Tomita T, Chou P, Reyes-Mugica M (1998) IV ventricle astrocytomas in childhood: clinicopathological features in 21 cases. Child’s Nerv Syst 14:537–546

    Article  CAS  Google Scholar 

  6. Arnold AC (1990) Internuclear ophthalmoplegia from intracranial tumor. J Clin Neuroophthalmol 10(4):278–286

    PubMed  CAS  Google Scholar 

  7. Keane JR (2005) Internuclear ophthalmoplegia: unusual causes in 114 of 410 patients. Arch Neurol 62:714–717

    Article  PubMed  Google Scholar 

  8. Okuda B, Tachibana H, Sugita M, Maeda Y (1993) Bilateral internuclear ophthalmoplegia, ataxia, and tremor from midbrain infarction. Stroke 23:481–482

    Article  Google Scholar 

  9. Mueller C, Koch S, Toifl K (1993) Transient bilateral internuclear ophthalmoplegia after minor head-trauma. Dev Med Child Neurol 35:158–176

    Google Scholar 

  10. Ushio M, Iwasaki S, Chihara Y, Murofushi T (2008) Walled-eyed bilateral internuclear ophthalmoplegia in a patient with progressive supranuclear palsy. J Neuro-Ophthalmol 28:93–96

    Article  Google Scholar 

  11. Menon V, Gogoi M, Saxena R, Singh S, Kumar A (2004) Isolated “One and a Half Syndrome” with brainstem tuberculoma. Indian J Pediatr 71(5):496–500

    Article  Google Scholar 

  12. Korkmaz A, Topaloglu H, Kansu T (2002) Wall-eyed bilateral internuclear ophthalmoplegia in chronic demyelinating polyneuropathy. Eur J Neurol 9:691–692

    Article  PubMed  CAS  Google Scholar 

  13. Zlatescu MC, TehraniYazdi AR, Sasaki H, Megyesi JF, Betensky RA, Louis DN, Cairncross JG (2001) Tumor location and growth pattern correlate with genetic signature in oligodendroglial neoplasms. Cancer Res 61:6713–6715

    PubMed  CAS  Google Scholar 

  14. Shin M, Nishihara T, Iai S, Eguchi T (2000) Benign aquaductal cyst causing bilateral internuclear ophthalmoplegia after external ventricular drainage. J Neurosurg 92:490–492

    Article  PubMed  CAS  Google Scholar 

  15. Gass A, Hennerici M (1997) Bilateral internuclear ophthalmoplegia in multiple sclerosis. J Neurol Neurosurg Psychiatr 63:564

    Article  PubMed  CAS  Google Scholar 

  16. Hughes TA, Wiles CM, Hourihan M (1994) Cervical radiculopathy and bilateral internuclear ophthalmoplegia caused by temporal arteritis. J Neurol 57:764–765

    CAS  Google Scholar 

  17. Misra AK, Mishra SK, Ortiz W (1994) Differential involvement of brainstem pathways due to forth ventricular epidermoid cyst: a case study. Clin Neurol Neurosurg 96:170–173

    Article  PubMed  CAS  Google Scholar 

  18. Sloane AE, Becker LE, Cyn Ang L, Wark J, Haslam RHA (1994) Neuronal intranuclear hyaline disease with progressive cerebellar ataxia. Pediatr Neurol 10:61–66

    Article  PubMed  CAS  Google Scholar 

  19. Crompton JL, Burrow DJ, Iyer PV (1989) Bilateral internuclear ophthalmoplegia- an unusual presenting sign of giant cell arteritis. J Ophthalmol 17(1):71–74

    CAS  Google Scholar 

  20. Cogen MS, Kline LB, Duvall ER (1987) Bilateral internuclear ophthalmoplegia in systemic lupus erythematous. J Neuro-Ophthalmol 7(2):69–73

    Article  CAS  Google Scholar 

  21. Woody RC, Reynolds JD (1985) Association of bilateral internuclear ophthalmoplegia and myelomeningocele with arnold-chiari malformation, type II. J Clin Neuroophthalmol 5(2):124–126

    PubMed  CAS  Google Scholar 

  22. Rosati G, Pinna L, Paolino E, D’Agostini G (1981) Reversible bilateral internuclear ophthalmoplegia due to head trauma: a case report. Eur Neurol 20:80–83

    Article  Google Scholar 

  23. Chen CM, Lin SH (2007) Walled-eyed bilateral internuclear ophthalmoplegia from lesions at different levels in brainstem. J Neuro-Ophthalmol 27:9–15

    Article  CAS  Google Scholar 

  24. Tekkok IH, Ayberk G, Kansu T, Suleyman S (1989) Bilateral internuclear ophthalmoplegia associated with fourth ventricular dermoid tumor. J Neuro-Ophthalmol 9(4):254–257

    CAS  Google Scholar 

  25. Netsky MG (1988) Epidermoid tumors: review of the literature. Surg Neurol 29:477–483

    Article  PubMed  CAS  Google Scholar 

  26. Schraeder PL, Cohen MM, Goldman W (1981) Bilateral internuclear ophthalmoplegia associated with fourth ventricular epidermoid tumor. J Neurosurg 54:403–405

    Article  PubMed  CAS  Google Scholar 

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The authors report no conflicts of interest.

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Correspondence to Neggy Rismanchi.

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Neggy Rismanchi MD PhD was responsible for drafting the manuscript for content, including medical writing, study concept and design, analysis and interpretation of the data. John Crawford MD MS was responsible for drafting the manuscript for content, including medical writing, study concept and design, analysis and interpretation of the data.

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Rismanchi, N., Crawford, J.R. Bilateral internuclear ophthalmoplegia associated with pediatric brain tumor progression: a case series and review of the literature. J Neurooncol 115, 487–491 (2013). https://doi.org/10.1007/s11060-013-1250-z

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  • DOI: https://doi.org/10.1007/s11060-013-1250-z

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