M& J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, India.
Department of Pediatric Ophthalmology and Strabismus, M & J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, India.
J Binocul Vis Ocul Motil. 2023 Oct 2;73(4):121-123. Epub 2023 Jul 13.
A 22-year-old male was referred from the medicine department with the chief complaint of double vision for 2 months. The patient had suffered from dengue viral hemorrhagic encephalitis for 2 months for which intensive medical care was given. On ocular examination, both eyes (OU) showed limited adduction with contralateral abducting nystagmus on attempted horizontal gaze. Magnetic resonance imaging of brain showed pontine and midbrain hemorrhages which involved the region of medial longitudinal fasciculus and caused bilateral internuclear ophthalmoplegia (INO). Bilateral INO is very rare and most commonly caused by multiple sclerosis. The presentation of dengue fever causing midbrain and pontine hemorrhages which resulted in bilateral INOs has not been previously reported, to our knowledge.
一位 22 岁男性因双眼复视 2 个月就诊于内科。患者曾患登革热病毒性脑炎 2 个月，接受了强化治疗。眼部检查发现双眼内收受限，水平注视时出现对侧外展性眼球震颤。颅脑磁共振成像显示脑桥和中脑出血，累及内侧纵束区域，导致双侧核间性眼肌麻痹（INO）。双侧 INO 非常罕见，最常见的病因是多发性硬化症。据我们所知，此前尚未有报告称登革热引起中脑和脑桥出血导致双侧 INO。
