Internuclear Ophthalmoplegia Associated with Anti-TNFα Medication. (March 2015)

• Record Type: Journal Article
• Authors: Drury, Jonathan; Hickman, Simon J.
• Is Part Of: Strabismus. Volume 23:Number 1(2015:Mar.)
• Page Start: 30
• Page End: 32
• Publication Date: 2015-03
• Subjects: Strabismus -- Periodicals; Neurophysiology -- Periodicals; 617.762
• DOI: 10.3109/09273972.2014.999796
• Languages: English
• ISSNs: 0927-3972

Abstract

<abstract> <title>Abstract</title> <p> <italic>Aim</italic>: To describe the presentation of an internuclear ophthalmoplegia (INO) associated with the use of anti-tumor necrosis factor α (anti-TNFα) medication.</p> <p> <italic>Methods</italic>: A case report of a woman, aged 27 years, who developed facial numbness, blurred vision, and diplopia on right gaze. She had a history of Crohn's disease, which was being treated by the anti-TNFα drug, adalimumab. On examination, a left INO was found.</p> <p> <italic>Treatment</italic>: The patient was prescribed a short course of corticosteroids and adalimumab treatment was discontinued.</p> <p> <italic>Results</italic>: Magnetic resonance imaging demonstrated typical demyelinating lesions including one responsible for the INO. Following a short course of corticosteroids and the discontinuation of the adalimumab treatment, the INO resolved, resulting in a swift improvement of ocular motility over a 2-week period.</p> <p> <italic>Conclusion</italic>: Anti-TNFα therapies have been associated with the development of demyelinating diseases. The presentation of a brainstem syndrome in a patient on anti-TNFα therapy should lead to investigation for central nervous system demyelination and cessation of the medication.</p> </abstract>