Update on the medial longitudinal fasciculus syndrome. 2022

Seung-Han Lee, and Jae-Myung Kim, and Ji-Soo Kim
Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea. nrshlee@chonnam.ac.kr.

The medial longitudinal fasciculus is a key structure for conjugate horizontal eye movements by relaying signals from the abducens internuclear neurons to the medial rectus subdivision of the contralateral oculomotor nucleus. Thus, lesions involving the medial longitudinal fasciculus give rise to a typical neuro-ophthalmological sign, the internuclear ophthalmoplegia, which is characterized by impaired adduction of the ipsilesional eye and dissociated abducting nystagmus of the contralateral eye during attempted contralesional horizontal gaze. In addition, medial longitudinal fasciculus lesions may produce various other ocular motor abnormalities since the medial longitudinal fasciculus also conveys the signals for the control of the vestibulo-ocular reflex and smooth pursuit. Other possible ocular motor abnormalities include spontaneous vertical-torsional nystagmus, contraversive ocular tilt reaction, and impaired vestibulo-ocular reflex, especially for the contralesional posterior canal. Recognition of the ocular motor findings observed in the medial longitudinal fasciculus syndrome would aid in detection and localization of potentially grave lesions involving the brainstem.

UI MeSH Term Description Entries
D009759 Nystagmus, Pathologic Involuntary movements of the eye that are divided into two types, jerk and pendular. Jerk nystagmus has a slow phase in one direction followed by a corrective fast phase in the opposite direction, and is usually caused by central or peripheral vestibular dysfunction. Pendular nystagmus features oscillations that are of equal velocity in both directions and this condition is often associated with visual loss early in life. (Adams et al., Principles of Neurology, 6th ed, p272) Convergence Nystagmus,Horizontal Nystagmus,Jerk Nystagmus,Pendular Nystagmus,Periodic Alternating Nystagmus,Rotary Nystagmus,See-Saw Nystagmus,Vertical Nystagmus,Conjugate Nystagmus,Dissociated Nystagmus,Fatigable Positional Nystagmus,Multidirectional Nystagmus,Non-Fatigable Positional Nystagmus,Permanent Nystagmus,Rebound Nystagmus,Retraction Nystagmus,Rotational Nystagmus,Spontaneous Ocular Nystagmus,Symptomatic Nystagmus,Temporary Nystagmus,Unidirectional Nystagmus,Non Fatigable Positional Nystagmus,Nystagmus, Conjugate,Nystagmus, Convergence,Nystagmus, Dissociated,Nystagmus, Fatigable Positional,Nystagmus, Horizontal,Nystagmus, Jerk,Nystagmus, Multidirectional,Nystagmus, Non-Fatigable Positional,Nystagmus, Pendular,Nystagmus, Periodic Alternating,Nystagmus, Permanent,Nystagmus, Rebound,Nystagmus, Retraction,Nystagmus, Rotary,Nystagmus, Rotational,Nystagmus, See-Saw,Nystagmus, Spontaneous Ocular,Nystagmus, Symptomatic,Nystagmus, Temporary,Nystagmus, Unidirectional,Nystagmus, Vertical,Ocular Nystagmus, Spontaneous,Pathologic Nystagmus,Positional Nystagmus, Non-Fatigable,See Saw Nystagmus
D012027 Reflex, Vestibulo-Ocular A reflex wherein impulses are conveyed from the cupulas of the SEMICIRCULAR CANALS and from the OTOLITHIC MEMBRANE of the SACCULE AND UTRICLE via the VESTIBULAR NUCLEI of the BRAIN STEM and the median longitudinal fasciculus to the OCULOMOTOR NERVE nuclei. It functions to maintain a stable retinal image during head rotation by generating appropriate compensatory EYE MOVEMENTS. Vestibulo-Ocular Reflex,Reflex, Vestibuloocular,Reflexes, Vestibo-Ocular,Reflexes, Vestibuloocular,Reflex, Vestibulo Ocular,Reflexes, Vestibo Ocular,Vestibo-Ocular Reflexes,Vestibulo Ocular Reflex,Vestibuloocular Reflex,Vestibuloocular Reflexes
D005133 Eye Movements Voluntary or reflex-controlled movements of the eye. Eye Movement,Movement, Eye,Movements, Eye
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012438 Saccades An abrupt voluntary shift in ocular fixation from one point to another, as occurs in reading. Pursuit, Saccadic,Saccadic Eye Movements,Eye Movement, Saccadic,Eye Movements, Saccadic,Movement, Saccadic Eye,Movements, Saccadic Eye,Pursuits, Saccadic,Saccade,Saccadic Eye Movement,Saccadic Pursuit,Saccadic Pursuits
D013577 Syndrome A characteristic symptom complex. Symptom Cluster,Cluster, Symptom,Clusters, Symptom,Symptom Clusters,Syndromes
D015835 Ocular Motility Disorders Disorders that feature impairment of eye movements as a primary manifestation of disease. These conditions may be divided into infranuclear, nuclear, and supranuclear disorders. Diseases of the eye muscles or oculomotor cranial nerves (III, IV, and VI) are considered infranuclear. Nuclear disorders are caused by disease of the oculomotor, trochlear, or abducens nuclei in the BRAIN STEM. Supranuclear disorders are produced by dysfunction of higher order sensory and motor systems that control eye movements, including neural networks in the CEREBRAL CORTEX; BASAL GANGLIA; CEREBELLUM; and BRAIN STEM. Ocular torticollis refers to a head tilt that is caused by an ocular misalignment. Opsoclonus refers to rapid, conjugate oscillations of the eyes in multiple directions, which may occur as a parainfectious or paraneoplastic condition (e.g., OPSOCLONUS-MYOCLONUS SYNDROME). (Adams et al., Principles of Neurology, 6th ed, p240) Brown Syndrome,Brown Tendon Sheath Syndrome,Brown's Syndrome,Convergence Insufficiency,Eye Movement Disorders,Internuclear Ophthalmoplegia,Ocular Torticollis,Opsoclonus,Parinaud Syndrome,Skew Deviation,Smooth Pursuit Deficiency,Brown's Tendon Sheath Syndrome,Convergence Excess,Cyclophoria,Deficiency, Smooth Pursuit,Eye Motility Disorders,Parinaud's Syndrome,Paroxysmal Ocular Dyskinesia,Pseudoophthalmoplegia,Spasm of Conjugate Gaze,Syndrome, Brown's Tendon Sheath,Tendon Sheath Syndrome of Brown,Browns Syndrome,Conjugate Gaze Spasm,Conjugate Gaze Spasms,Convergence Excesses,Convergence Insufficiencies,Cyclophorias,Deficiencies, Smooth Pursuit,Deviation, Skew,Deviations, Skew,Dyskinesia, Paroxysmal Ocular,Dyskinesias, Paroxysmal Ocular,Excess, Convergence,Eye Motility Disorder,Eye Movement Disorder,Gaze Spasms, Conjugate,Insufficiencies, Convergence,Insufficiency, Convergence,Internuclear Ophthalmoplegias,Ocular Dyskinesia, Paroxysmal,Ocular Dyskinesias, Paroxysmal,Ocular Motility Disorder,Ophthalmoplegia, Internuclear,Ophthalmoplegias, Internuclear,Parinauds Syndrome,Paroxysmal Ocular Dyskinesias,Pseudoophthalmoplegias,Pursuit Deficiencies, Smooth,Pursuit Deficiency, Smooth,Skew Deviations,Smooth Pursuit Deficiencies,Syndrome, Brown,Syndrome, Brown's,Syndrome, Parinaud,Syndrome, Parinaud's

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