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1 results

  • Left vertebral artery dissection causing bilateral internuclear ophthalmoplegia

  • Glen Jickling, Kelvin Leung, Kenman Gan, Ashfaq Shuaib, James Lewis, Mikael S. Mouradian
  • Journal:
    Canadian Journal of Emergency Medicine / Volume 10 / Issue 5 / September 2008
    Published online by Cambridge University Press:
    21 May 2015, pp. 485-487
    Print publication:
    September 2008
    • Article
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  • A 21-year-old woman presented to the emergency department 1 day after a fall. On the day of presentation, she awoke with horizontal diplopia and posterior neck pain. Based on clinical findings, she was diagnosed with bilateral internuclear ophthalmoplegia. A conventional angiogram identified a left vertebral artery dissection. She was started on anticoagulant therapy, with gradual improvement of her diplopia over several months. Diplopia is frequently seen in the emergency department. Internuclear ophthalmoplegia is a cause of binocular diplopia and is important to recognize because it indicates a brainstem lesion requiring neurologic evaluation.