Síndrome de WEBINO (wall-eyed bilateral internuclear ophthalmoplegia) secundario a ictus isquémico, a propósito de un caso / WEBINO syndrome (wall-eyed bilateral internuclear ophthalmoplegia) secondary to ischemic stroke, about a case

El síndrome de WEBINO (wall-eyed bilateral internuclear ophthalmoplegia) se caracteriza por un déficit bilateral en la aducción ocular, nistagmo horizontal bilateral a la abducción, así como la presencia de exotropía en la mirada primaria. Presentamos el caso de un paciente varón de 68 años que se presentó en el servicio de urgencias con diplopía de inicio súbito. La exploración fue compatible con síndrome de WEBINO, y también presentaba ataxia de la marcha. Entre los antecedentes relevantes, constaba que era trasplantado hepático en tratamiento con tacrolimus. Las exploraciones complementarias pusieron de manifiesto la existencia de una lesión isquémica en tegmento mesencefálico, involucrando el fascículo longitudinal medial de forma bilateral, así como el área pretectal. El síndrome de WEBINO es un síndrome poco frecuente. Entre las etiologías destacan la isquémica y la desmielinizante como las más frecuentes. En nuestro caso también se consideró la iatrogenia. La lesión asienta en un área anatómica específica, siendo clave su conocimiento para la realización de exploraciones complementarias que lleven al diagnóstico etiológico específico

WEBINO (wall-eyed bilateral internuclear ophthalmoplegia) syndrome is characterized by bilateral adduction impairment, nystagmus of the abducting eye, and primary gaze exotropia. We present the case of a 68 year-old man who was initially attended in emergency department with sudden onset diplopia. Neurological exploration revealed WEBINO and gait ataxia. Relevant medical history included liver transplantation and subsequent tacrolimus prescription. Complementary exams revealed ischemic lesion in mesencephalic tegmentum, involving medial longitudinal fasciculus and pretectal area. WEBINO syndrome is unfrequent. Among its etiologies, ischemic and demyelinating are the most frequent. In our case, iatrogenic etiology was also considered. Clinical recognition of this syndrome is required to perform adequate exams in order to reach diagnosis

WEBINO syndrome (wall-eyed bilateral internuclear ophthalmoplegia) secondary to ischemic stroke, about a case. / Síndrome de WEBINO (wall-eyed bilateral internuclear ophthalmoplegia) secundario a ictus isquémico, a propósito de un caso.

WEBINO (wall-eyed bilateral internuclear ophthalmoplegia) syndrome is characterized by bilateral adduction impairment, nystagmus of the abducting eye, and primary gaze exotropia. We present the case of a 68 year-old man who was initially attended in emergency department with sudden onset diplopia. Neurological exploration revealed WEBINO and gait ataxia. Relevant medical history included liver transplantation and subsequent tacrolimus prescription. Complementary exams revealed ischemic lesion in mesencephalic tegmentum, involving medial longitudinal fasciculus and pretectal area. WEBINO syndrome is unfrequent. Among its etiologies, ischemic and demyelinating are the most frequent. In our case, iatrogenic etiology was also considered. Clinical recognition of this syndrome is required to perform adequate exams in order to reach diagnosis.