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Bilateral internuclear ophthalmoplegia related to chronic toluene abuse
1Neuro-Ophthalmology Unit of the Wilmer Eye Institute, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
Abstract:
A 36-year-old woman exhibited slurred speech, progressive ataxia, blurred vision, and oscillopsia. Examination showed dysconjugate torsional nystagmus and bilateral internuclear ophthalmoplegia (INO). Further investigation revealed evidence of chronic toluene abuse. The neurologic findings in toluene abuse and the causes of bilateral INO are discussed.