Left vertebral artery dissection causing bilateral internuclear ophthalmoplegia

Glen Jickling, Kelvin Leung, Kenman Gan, Ashfaq Shuaib, James Lewis, Mikael S. Mouradian

Research output: Contribution to journalArticle


A 21-year-old woman presented to the emergency department 1 day after a fall. On the day of presentation, she awoke with horizontal diplopia and posterior neck pain. Based on clinical findings, she was diagnosed with bilateral internuclear ophthalmoplegia. A conventional angiogram identified a left vertebral artery dissection. She was started on anticoagulant therapy, with gradual improvement of her diplopia over several months. Diplopia is frequently seen in the emergency department. Internuclear ophthalmoplegia is a cause of binocular diplopia and is important to recognize because it indicates a brainstem lesion requiring neurologic evaluation.

Original languageEnglish (US)
Pages (from-to)485-487
Number of pages3
JournalCanadian Journal of Emergency Medicine
Issue number5
StatePublished - Sep 2008
Externally publishedYes


  • Bilateral internuclear ophthalmoplegia
  • Diplopia
  • Vertebral artery dissection

ASJC Scopus subject areas

  • Emergency Medicine

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  • Cite this

    Jickling, G., Leung, K., Gan, K., Shuaib, A., Lewis, J., & Mouradian, M. S. (2008). Left vertebral artery dissection causing bilateral internuclear ophthalmoplegia. Canadian Journal of Emergency Medicine, 10(5), 485-487.