MIDBRAIN INFARCTION WITH INTERNUCLEAR OPHTHALMOPLEGIA: A RARE PRESENTATION

Internuclear ophthalmoplegia (INO) is a distinctive ocular motility disorder caused by damage to the medial longitudinal fasciculus (MLF), often due to ischemic stroke. We report the case of a 67-year-old male presenting with INO due to an acute midbrain infarction. The patient exhibited adduction deficit in the left eye with abduction nystagmus in the right eye, gait ataxia, slurred speech, and intentional tremors. INO results from MLF disruption and is commonly associated with cerebrovascular accidents. MRI findings confirmed midbrain infarction as the underlying pathology. Midbrain infarction causing Internuclear ophthalmoplegia is usually very rare presentation. Very few cases have been reported in literature. Our case reported below is one such rare presentation. This case underscores the importance of considering midbrain infarction as a cause of INO, particularly in patients with significant vascular risk factors. Detailed clinical examination and neuroimaging are essential for accurate diagnosis and management.