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Internuclear ophthalmoparesis (INO) in multiple sclerosis (MS) is due to demyelination of the medial longitudinal fasciculus (MLF) and provides an accessible model for studying consequences of raised body temperature and fatigue on central demyelination.1,2 Prompted by one of our patient’s report of vision improvement after initiating dalfampridine, a potassium channel blocker prescribed for gait impairment,3 we measured this drug's effects on 3 patients with MS with bilateral INO. All showed changes in horizontal saccadic conjugacy consistent with improved transmission of the neural pulse responsible for adducting movements.
Acknowledgments
Acknowledgment: The authors thank Drs. John Leigh, John Stahl, and Elliott Frohman for advice and encouragement.
Footnotes
Author contributions: A. Serra: study concept and design, acquisition, analysis, and interpretation of data, manuscript writing and critical revision. M. Skelly: acquisition and analysis of data. J. Jacobs: acquisition and analysis of data. M. Walker: critical revision of the manuscript. J. Cohen: critical revision of the manuscript.
Study funding: Supported by the Office of Research and Development, Medical Research Service, Department of Veterans Affairs.
Disclosure: The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.
- Received October 19, 2013.
- Accepted in final form March 12, 2014.
- © 2014 American Academy of Neurology
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