Sandyk R, Brennan M J
Eur Neurol. 1984;23(3):148-50. doi: 10.1159/000115695.
Internuclear ophthalmoplegia (INO) is characteristic of lesions of the medial longitudinal fasciculus and usually indicates primary brain stem pathology. Here we describe 2 cases of tuberculous meningitis (TBM) in which INO was a prominent presenting sign. The mechanism of INO in TBM is presumed to be ischemia secondary to involvement of small basilar vessels supplying the MLF in the inflammatory process. In both cases the INO resolved on antituberculous therapy suggesting that the cause of the ischemia is reversible. INO in a patient with meningitis must suggest a basal process probably TBM.
核间性眼肌麻痹（INO）是内侧纵束病变的特征性表现，通常提示原发性脑干病变。我们在此描述2例结核性脑膜炎（TBM），其中INO是突出的首发症状。TBM中INO的机制推测是炎症过程中供应内侧纵束的小基底动脉受累继发缺血。在这2例中，INO在抗结核治疗后均消失，提示缺血原因是可逆的。脑膜炎患者出现INO必须考虑可能为TBM的基底病变。
