Cogan’s anterior internuclear ophthalmoplegia in young Ethiopian: A case report and review of literature

Abstract

Introduction: Lesions in medial longitudinal fasciculus (MLF) produce internuclear ophthalmoplegia (INO) with characteristic horizontal gaze abnormality. Here, the author reports a rare clinical spectrum of internuclear ophthalmoplegia called Cogan’s anterior internuclear ophthalmoplegia in young Ethiopian suspected to have multiple sclerosis. To the best of the author’s knowledge, this is the first report in non-white population near the equator.
Case presentation: A 19-year-old female Ethiopian patient presented with bilateral internuclear ophthalmoplegia. Attempted convergence was abnormal. The patient regained normal ocular mobility after six months of follow-up.
Conclusion: Isolated reversible internuclear ophthalmoplegia in a previously healthy young patient could be an initial manifestation of a serious illness like multiple sclerosis. Though the incidence of multiple sclerosis in non-white population near the equator is low, high index of suspicion and close follow up are warranted.

KEYWORDS Medial longitudinal fasciculus lesion; Internuclear ophthalmoplegia; Horizontal gaze abnormality; Multiple sclerosis