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June 1976

Pseudo-Internuclear Ophthalmoplegia in Polyneuritis

Author Affiliations

Dept of Neurology Edward J. Meyer Memorial Hosp Buffalo, NY 14215

Arch Neurol. 1976;33(6):457. doi:10.1001/archneur.1976.00500060063017

Recently, we noted a disturbance of ocular motility simulating internuclear ophthalmoplegia during the early stage of the Guillain-Barré syndrome. A similar ocular picture of pseudo-internuclear ophthalmoplegia of peripheral origin has been reported in myasthenia gravis1-3 and in one case of Fisher syndrome of ophthalmoplegia, ataxia, and areflexia.4

Report of a Case.—  A 23-year-old man had double vision of two days' duration. On the day of admission, the following symptoms developed: difficulty in retaining fluids in his mouth and in pursing his lips, numbness of mouth, impairment of taste appreciation, and "imbalance" on walking. Neurologically, there was slight difficulty in articulation, a negative Romberg test, and some impairment of heel-toe walking, which was difficult to assess in view of a short leg and pes cavus on the left. Cranial nerve functions were normal except for some paresis of the right lateral rectus, which was not improved on the edrophonium test

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