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Medial Longitudinal Fasciculus on MRI in a Patient with Internuclear Ophthalmoparesis: A Case Report

신경핵사이 눈근육마비환자에서 자기공명영상에서의 내측세로다발: 증례 보고

  • Kim, Sung Min (Department of Radiology, Catholic University of Daegu School of Medicine) ;
  • Kim, Ho Kyun (Department of Radiology, Catholic University of Daegu School of Medicine) ;
  • Lee, Hui Joong (Department of Radiology, Kyungpook National University Hospital)
  • 김성민 (대구가톨릭대학교병원 영상의학과) ;
  • 김호균 (대구가톨릭대학교병원 영상의학과) ;
  • 이희중 (경북대학교병원 영상의학과)
  • Received : 2014.05.15
  • Accepted : 2014.06.16
  • Published : 2014.06.30

Abstract

The medial longitudinal fasciculus (MLF) is myelinated composite tract, lying near the midline, ventral to periaqueductal grey matter that plays a key role in coordinating eye movements. A lesion of the MLF results in an ipsilateral adduction deficit and a contralateral abducting nystagmus, referred to as an internuclear ophthalmoparesis. The blended tract with adjacent white matter in pons and midbrain is indistinguishable on brain imaging such as CT and MRI. Until now, to the best of our knowledge, MLF is not delineated on in vivo MRI. We present a case showing the whole connecting courses of MLF lesion on MRI in a patient with inflammatory demyelinating disorder.

내측세로다발은 조화로운 눈운동의 핵심적인 역할을 하는 유수 합성로이며 수도관주위회색질의 배쪽의 중간선 근처에 놓여있다. 내측세로다발의 병변은 신경핵사이 눈근육마비로 불리는 동측의 내전 결손과 반대측 외전 안진을 야기한다. 중뇌와 교뇌에서 인접한 백질과 섞여있는 신경로는 전산화단층촬영술과 자기공명영상과 같은 뇌영상에서 구별하기 어렵다. 지금까지 우리가 알기로는 내측세로다발은 실제 자기공명영상에서 구체적으로 묘사되지 않았다. 우리는 염증성 탈수초성 질환에서 자기공명영상에 내측세로다발의 전체 연결 과정을 보이는 증례를 보고한다.

Keywords

References

  1. Standring S. Gray's anatomy. In. 39th ed. London: Churchill Livingstone, 2004.
  2. Pola J, Robinson DA. An explanation of eye movements seen in internuclear ophthalmoplegia. Arch Neurol 1976;33:447-452 https://doi.org/10.1001/archneur.1976.00500060053011
  3. Highstein SM, Baker R. Excitatory termination of abducens internuclear neurons on medial rectus motoneurons: relationship to syndrome of internuclear ophthalmoplegia. J Neurophysiol 1978;41:1647-1661 https://doi.org/10.1152/jn.1978.41.6.1647
  4. Carpenter MB. Core text of Neuroanatomy. In. 4th Ed. ed. Baltimore: Williams & Wilkins, 1991.
  5. Hirose G, Furui K, Yoshioka A, Sakai K. Unilateral conjugate gaze palsy due to a lesion of the abducens nucleus. Clinical and neuroradiological correlations. In: Journal of clinical neuroophthalmology, 1993; 54-58.
  6. Frohman EM, Zhang H, Kramer PD, et al. MRI characteristics of the MLF in MS patients with chronic internuclear ophthalmoparesis. Neurology 2001;57:762-768 https://doi.org/10.1212/WNL.57.5.762
  7. Keane JR. Internuclear ophthalmoplegia: unusual causes in 114 of 410 patients. In: Arch Neurol, 2005;714-717
  8. Atlas SW, Grossman RI, Savino PJ, et al. Internuclear ophthalmoplegia: MR-anatomic correlation. AJNR Am J Neuroradiol 1987;8:243-247
  9. Napadow V, Dhond R, Kennedy D, Hui KK, Makris N. Automated brainstem co-registration (ABC) for MRI. Neuroimage 2006;32:1113-1119 https://doi.org/10.1016/j.neuroimage.2006.05.050
  10. Sakaie K, Takahashi M, Dimitrov I, et al. Diffusion tensor imaging the medial longitudinal fasciculus in INO: opportunities and challenges. In: Annals of the New York Academy of Sciences, 2011;307-312

Cited by

  1. The Medial Longitudinal Fasciculus and Internuclear Opthalmoparesis: There’s More Than Meets the Eye vol.12, pp.8, 2014, https://doi.org/10.7759/cureus.9959