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Letter
Lesion responsible for WEMINO syndrome confirmed by magnetic resonance imaging
  1. Y Ikeda,
  2. K Okamoto
  1. Department of Neurology, Gunma University School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Japan
  1. Correspondence to:
 Dr Y Ikeda;
 yikeda{at}med.gunma-u.ac.jp

https://doi.org/10.1136/jnnp.73.2.204

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    WEMINO (wall eyed monocular internuclear ophthalmoplegia) syndrome is a rare neurological impairment involving disconjugate ocular movements.1 Neuroradiological findings of the lesion responsible for WEMINO syndrome have not been reported to date. We report a case of the syndrome in which cerebral magnetic resonance imaging (MRI) clearly showed a tiny isolated lesion causing this impairment.

    The patient was a 61 year old Japanese man who had been admitted to hospital for surgery for mitral regurgitation. He had a two year history of mitral incompetence, and mitral valve plasty was completed successfully on 21 September 2000. There were no postoperative problems.

    On the afternoon of 27 September, one week after the operation, he suddenly experienced double vision, and was found to have left exotropia without blepharoptosis. On neurological examination, adduction of left eye was disturbed and it could not move beyond the midline of orbit, although full abduction was possible. Bilateral upward nystagmus was noted on forward gaze. Right ocular movement was not disturbed in any direction, but horizontal nystagmus appeared on rightward gaze. There …

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