Bilateral internal ophthalmoplegia as a feature of oculomotor fascicular syndrome disclosed by magnetic resonance imaging.

Abstract

To describe the magnetic resonance imaging features of bilateral internal ophthalmoplegia as an oculomotor fascicular syndrome. A 55-year-old man was initially examined with bilateral photophobia. Neuro-ophthalmologic examinations disclosed preganglionic bilateral internal ophthalmoplegia. Magnetic resonance imaging of the brainstem was performed. Magnetic resonance imaging disclosed high-intensity areas on T2-weighted images along medial portions of the bilateral oculomotor fascicles in the mesencephalon. These findings suggest that mesencephalic lesions may selectively cause bilateral internal ophthalmoplegia as a partial oculomotor fascicular syndrome.