BINO & Lightheadness?

[seal]

I have Bilateral Intranuclear Ophtamoplegia. For the past couple of weeks, it's been pretty bad. Nothing I can't deal with (just rather wouldn't) Images take a few seconds to "line up".

I have also been lightheaded.

I think the BINO is causing the lightheadness to be a little worse then it normally is.

Does any one else this issue and, if so, how do you deal with it?

Thanks for any input.

[mjan]

I just wanted to acknowledge your plight and say how sorry I am for all you are enduring. I have never heard of BINO and wonder too if anyone on here has.

Have you tried any other online support sites for BINO? There is DailyStrength.org and others that cover many disorders. Not sure if they even cover BINO.

Is it kind of rare?

Does your neuro have any advice or educational resources?

Anyway, let us know how you are doing and my hope is that you find some kind of relief!

Hugs, Jan

[22cyclist]

Hi: I have BINO permanently now. Mine did not clear up. I had/have double vision with it, and now have to wear prisms in my glasses for it. As far as the dizziness goes, I have that too constantly now. I take Valium for it. It helps. I hope that when your BINO improves, you will go back to your normal level of dizziness...funny to say that, right? Dizziness does come with the MLF lesion.

I am so sorry this is happening to you. Let us know how you come along in your recovery, OK?

Take care
Lisa
Moderation Team

[22cyclist]

I just wanted to acknowledge your plight and say how sorry I am for all you are enduring. I have never heard of BINO and wonder too if anyone on here has.

Have you tried any other online support sites for BINO? There is DailyStrength.org and others that cover many disorders. Not sure if they even cover BINO.

Is it kind of rare?

Does your neuro have any advice or educational resources?

Anyway, let us know how you are doing and my hope is that you find some kind of relief!

Hugs, Jan

Hi Jan. I don't think it is that uncommon in MS patients, and in those who get it who are not yet diagnosed, there is a 95% chance that it is MS when it is bilateral at diagnosis.

Internuclear ophthalmoplegia (INO) is a specific gaze abnormality characterized by impaired horizontal eye movement with weak adduction of the affected eye and abduction nystagmus of the contralateral eye. It is one of the most localizing brainstem syndromes, resulting from a lesion in the medial longitudinal fasciculus (MLF) in the dorsomedial brainstem tegmentum of either the pons or the midbrain.

Visual targeting with binocular fusion and depth perception requires highly synchronous eye movements that place objects of visual interest on the corresponding points of both retinas. This process is dependent upon the precise coordination between cranial nerves III, IV, and VI and their interneuronal pathways that project through the medial longitudinal fasciculus (MLF).

The paramedian pontine reticular formation (PPRF) is often referred to as the conjugate gaze center for horizontal eye movements. During horizontal eye movement, the PPRF burst cells innervate the abducens nucleus, which contains two distinctive sets of neurons. Axons from the abducens motorneurons innervate the ipsilateral lateral rectus muscle. Axons of the abducens interneurons cross the midline to become the MLF and subsequently innervate the medial rectus subnucleus of the oculomotor complex (cranial nerve nucleus III) and finally the medial rectus muscle.

The MLF exists as a pair of white matter fiber tracts that lie near the midline just under the fourth ventricle and cerebral aqueduct and extend through the dorsomedial pontine and midbrain tegmentum. Because of their close physical proximity, bilateral injury is common.

An internuclear ophthalmoplegia (INO) results from injury to the MLF within the dorsomedial pontine or midbrain tegmentum. The side of the INO is named by the side of the adduction deficit, which is ipsilateral to the medial longitudinal fasciculus (MLF) lesion. BINO or Bilateral internuclear ophthalmoplegia results from injury to both sides of the MLF. This is often the case in multiple sclerosis.

Source:
http://www.uptodate.com/contents/int...phthalmoplegia

Take care
Lisa
Moderation Team

[mjan]

Hi Jan. I don't think it is that uncommon in MS patients, and in those who get it who are not yet diagnosed, there is a 95% chance that it is MS when it is bilateral at diagnosis.

Internuclear ophthalmoplegia (INO) is a specific gaze abnormality characterized by impaired horizontal eye movement with weak adduction of the affected eye and abduction nystagmus of the contralateral eye. It is one of the most localizing brainstem syndromes, resulting from a lesion in the medial longitudinal fasciculus (MLF) in the dorsomedial brainstem tegmentum of either the pons or the midbrain.

Visual targeting with binocular fusion and depth perception requires highly synchronous eye movements that place objects of visual interest on the corresponding points of both retinas. This process is dependent upon the precise coordination between cranial nerves III, IV, and VI and their interneuronal pathways that project through the medial longitudinal fasciculus (MLF).

The paramedian pontine reticular formation (PPRF) is often referred to as the conjugate gaze center for horizontal eye movements. During horizontal eye movement, the PPRF burst cells innervate the abducens nucleus, which contains two distinctive sets of neurons. Axons from the abducens motorneurons innervate the ipsilateral lateral rectus muscle. Axons of the abducens interneurons cross the midline to become the MLF and subsequently innervate the medial rectus subnucleus of the oculomotor complex (cranial nerve nucleus III) and finally the medial rectus muscle.

The MLF exists as a pair of white matter fiber tracts that lie near the midline just under the fourth ventricle and cerebral aqueduct and extend through the dorsomedial pontine and midbrain tegmentum. Because of their close physical proximity, bilateral injury is common.

An internuclear ophthalmoplegia (INO) results from injury to the MLF within the dorsomedial pontine or midbrain tegmentum. The side of the INO is named by the side of the adduction deficit, which is ipsilateral to the medial longitudinal fasciculus (MLF) lesion. BINO or Bilateral internuclear ophthalmoplegia results from injury to both sides of the MLF. This is often the case in multiple sclerosis.

Source:
http://www.uptodate.com/contents/int...phthalmoplegia

Take care
Lisa
Moderation Team

Ah... thanks? LOL
Very thorough.. sorry you have this, Lisa

Hugs, Jan

[Mable]

I had internuclear ophthomaplegia. It's how I got diagnosed. By the time I got diagnosed and in for my week of steroids, I had some paralysis on my face, and my eyes could no longer track my head. I mean, if I turned my head, my eyes couldn't follow right away. Ah, the sorts of things you take for granted until you lose them!

Anyway, after the steroids, my paralysis went away and the eye tracking got better. The double vision took a couple months more to go away completely.

I'm left with light headedness that comes and goes. On good days, when I get lots of sleep, stay off the computer, and it's not too hot, I'm just about my old normal self. Other times, I'm pretty wobbly.

It looks to me like you have a lot of attacks, seal. Are you on a DMT?

[seal]

Thanks you all for your replies.

Mable, I'm on Copaxane.

I think, like you, it's my "new normal". Tired, hot, computer, phases of the moon (just joking on that one!), you just never know.

Next Neuro appointment, I will ask him about valium or some other med to help. It's not constant (most of the time), so I'm not sure about prisms

thanks again all.