The authors report a case of traumatic internuclear ophthalmoplegia an
d discuss its pathophysiologic mechanism. Internuclear ophthalmoplegia
due to head trauma is uncommon, though it may be more common than rep
orted since signs and symptoms typically resolve over weeks to months,
and in multiple trauma patients other serious injuries overshadow dis
turbances of eye movements. A lesion involving medial longitudinal fas
ciculus was found by magnetic resonance imaging in the early post-trau
matic period; this lesion was not seen when routine X-ray computed tom
ography was performed at the time of injury, confirming that magnetic
resonance scanning is definitely superior to computed tomography tor e
valuating internuclear ophthalmoplegia.