Internuclear ophthalmoplegia
Horizontal gaze centers
Diplopia midbrain Infarction Hemorrhage Neoplasm Demylination Subarachnoid portion Infarction Hemorrhage Neoplasm Demylination Aneurysm Infectious meningitis Meningeal infiltration granulomatous inflammation Rise intracranial pressure (VI) Trauma (IV) Cerebello-pontine angle tumour 3
Diplopia Cavernous sinus Orbit Vascular Infection Tumor Granuloma Aneurysm Carotid artery- cavernous sinus fistula Cavernous sinus thrombosis Ischemia from microvascular disease in vasa nervosa Inflammatory Vascular Infection Tumor Granuloma Trauma 4
Investigations
Investigations
Ptosis
Ptosis Partial Complete
Ptosis Muscle disease Myasthenia Gravis
Horner's syndrome
Pupil disorders Dilated III lesion Trauma Anticholinergi cs & Sympathmime tics intoxication Ethanol & sedative withdrawal
Pupil disorders Cosntrection Opioid intoxication Argyll Robertson pupil Holmes Adie pupil Horner's syndrome
Pathway for pupillary dilatation (sympathetic) hypothalamus brain stem cervical spinal cord C8, T1 sympathetic chain superior cervical ganglion internal carotid artery ciliary ganglion dilator pupillae in the iris
A lesion anywhere along its path results in Horner’s syndrome A lesion anywhere along its path results in Miosis Ptosis enopthalmos anhydrosis.