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Reversible bilateral internuclear ophthalmoplegia associated with FK506
  1. M M Lai,
  2. J B Kerrison,
  3. N R Miller
  1. Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, USA
  1. Correspondence to:
 Dr N R Miller
 Wilmer Eye Institute, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA;


A 50 year old man developed tonic-clonic seizures while receiving cyclosporin A after orthotopic cardiac transplant. The seizures resolved after cessation of cyclosporin A. Thirteen months later, he developed diplopia from bilateral internuclear ophthalmoplegia while receiving intravenous FK506. A temporal association was found between his symptoms and the serum FK506 concentrations. Withdrawal of the intravenous FK506 led to prompt resolution of the bilateral internuclear ophthalmoplegia.

  • FK506
  • cyclosporin A
  • internuclear ophthalmoplegia
  • MRI, magnetic resonance imaging
  • CsA, cyclosporin A
  • INO, internuclear ophthalmoplegia

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  • Competing interests: none declared