Division of Child Neurology, Department of Neurosciences, University of California San Diego, Rady Children's Hospital, 8010 Frost Street Suite 400, San Diego, CA, 92123, USA,
J Neurooncol. 2013 Dec;115(3):487-91. doi: 10.1007/s11060-013-1250-z. Epub 2013 Sep 19.
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.
眼肌核间性眼肌麻痹（INO）是一种罕见的眼球侧向共轭运动障碍，已在多种神经系统疾病中描述，包括多发性硬化症、中风，以及较少见的脑肿瘤。我们描述了一系列 3 名男孩（11、12、15 岁）的病例，他们被诊断为原发性中枢神经系统肿瘤（毛细胞型星形细胞瘤变异型、间变性少突星形细胞瘤、脑胶质细胞瘤病），随着疾病的进展，出现了双侧 INO。从诊断到双侧 INO 发展的时间范围为 13-36 个月。所有患儿在诊断为双侧 INO 后 1-9 个月内均因疾病死亡，且在进展时磁共振成像上有明显的背侧脑桥侵犯。只有一个患儿在诊断时就有脑干受累。我们的病例系列强调了这种罕见的双侧 INO 眼肌麻痹综合征与肿瘤进展相关，并对脑肿瘤与 INO 的关联进行了文献回顾。
