[The WEBINO syndrome as presentation form of myasthenia gravis]

We report the case of a 37-year-old male that came to emergency with diplopia of sudden onset. Ocular examination revealed severe exotropia, deficiency of convergence and the typical sings of bilateral internuclear ophthalmoplegia (INO): absence of adduction and nistagmic abduction of both eyes. All the symptoms of this patient constitute the WEBINO (wall eyed bilateral ophthalmoplegia) syndrome.

The most common causes of bilateral INO (multiple sclerosis, vascular accidents, etc.) were discarded and a diagnosis of Myasthenia gravis was made on the basis of Tensilon test and electromiography. Treatment with piridostigmina achieved in two months the complete remission of the signs and symptoms. This is the first description of WEBINO syndrome due to Myasthenia gravis.