WEBINO and the rturn of tHe King's Speech

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

We present a 69 year-old man with hypertension who developed the sudden onset of horizontal binocular diplopia and stuttering of speech. On examination, bilateral exotropia (i.e. 'wall-eyed') was observed in the primary position. Attempted horizontal saccades revealed bilateral internuclear ophthalmoplegia; all consistent with the wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome. Convergence, vertical saccades and vestibular ocular reflexes were likewise impaired. Pupillary and levator palpebrae superioris functions were intact. Mild left-sided dysmetria, intention tremor and dysdiadochokinesia were elicited. Conspicuously, further characterization of the patient's history revealed that he had stuttered as a child, but it had resolved in adolescence. Brain MRI revealed an acute infarction of the mesencephalic and upper pontine tegmentum involving the periaqueductal gray region and the medial longitudinal fasciculus bilaterally with greater involvement of the left. Like the WEBINO syndrome, re-emergent developmental stuttering is a rare neurologic phenomenon. To our knowledge, this is the first case report of a mesencephalic and upper pontine infarction causing both syndromes. We discuss the pathobiological underpinnings of the WEBINO syndrome and neurogenic stuttering and in relationship to this unusual case.

Original languageEnglish (US)
Pages (from-to)153-155
Number of pages3
JournalJournal of the Neurological Sciences
Volume315
Issue number1-2
DOIs
StatePublished - Apr 15 2012

Fingerprint

Ocular Motility Disorders
Stuttering
Saccades
Infarction
Oculomotor Muscles
Exotropia
Cerebellar Ataxia
Periaqueductal Gray
Diplopia
Tremor
Nervous System
Reflex
Hypertension
Brain

Keywords

  • Bilateral internuclear ophthalmoplegia
  • Midbrain
  • Neuro-ophthalmology
  • Neurogenic stuttering
  • Periaqueductal gray
  • Stuttering
  • WEBINO syndrome

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

WEBINO and the rturn of tHe King's Speech. / Beh, Shin C; Frohman, Elliot.

In: Journal of the Neurological Sciences, Vol. 315, No. 1-2, 15.04.2012, p. 153-155.

Research output: Contribution to journalArticle

@article{4831437007d34ec3b4e9731e5c711659,
title = "WEBINO and the rturn of tHe King's Speech",
abstract = "We present a 69 year-old man with hypertension who developed the sudden onset of horizontal binocular diplopia and stuttering of speech. On examination, bilateral exotropia (i.e. 'wall-eyed') was observed in the primary position. Attempted horizontal saccades revealed bilateral internuclear ophthalmoplegia; all consistent with the wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome. Convergence, vertical saccades and vestibular ocular reflexes were likewise impaired. Pupillary and levator palpebrae superioris functions were intact. Mild left-sided dysmetria, intention tremor and dysdiadochokinesia were elicited. Conspicuously, further characterization of the patient's history revealed that he had stuttered as a child, but it had resolved in adolescence. Brain MRI revealed an acute infarction of the mesencephalic and upper pontine tegmentum involving the periaqueductal gray region and the medial longitudinal fasciculus bilaterally with greater involvement of the left. Like the WEBINO syndrome, re-emergent developmental stuttering is a rare neurologic phenomenon. To our knowledge, this is the first case report of a mesencephalic and upper pontine infarction causing both syndromes. We discuss the pathobiological underpinnings of the WEBINO syndrome and neurogenic stuttering and in relationship to this unusual case.",
keywords = "Bilateral internuclear ophthalmoplegia, Midbrain, Neuro-ophthalmology, Neurogenic stuttering, Periaqueductal gray, Stuttering, WEBINO syndrome",
author = "Beh, {Shin C} and Elliot Frohman",
year = "2012",
month = "4",
day = "15",
doi = "10.1016/j.jns.2011.11.035",
language = "English (US)",
volume = "315",
pages = "153--155",
journal = "Journal of the Neurological Sciences",
issn = "0022-510X",
publisher = "Elsevier",
number = "1-2",

}

TY - JOUR

T1 - WEBINO and the rturn of tHe King's Speech

AU - Beh, Shin C

AU - Frohman, Elliot

PY - 2012/4/15

Y1 - 2012/4/15

N2 - We present a 69 year-old man with hypertension who developed the sudden onset of horizontal binocular diplopia and stuttering of speech. On examination, bilateral exotropia (i.e. 'wall-eyed') was observed in the primary position. Attempted horizontal saccades revealed bilateral internuclear ophthalmoplegia; all consistent with the wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome. Convergence, vertical saccades and vestibular ocular reflexes were likewise impaired. Pupillary and levator palpebrae superioris functions were intact. Mild left-sided dysmetria, intention tremor and dysdiadochokinesia were elicited. Conspicuously, further characterization of the patient's history revealed that he had stuttered as a child, but it had resolved in adolescence. Brain MRI revealed an acute infarction of the mesencephalic and upper pontine tegmentum involving the periaqueductal gray region and the medial longitudinal fasciculus bilaterally with greater involvement of the left. Like the WEBINO syndrome, re-emergent developmental stuttering is a rare neurologic phenomenon. To our knowledge, this is the first case report of a mesencephalic and upper pontine infarction causing both syndromes. We discuss the pathobiological underpinnings of the WEBINO syndrome and neurogenic stuttering and in relationship to this unusual case.

AB - We present a 69 year-old man with hypertension who developed the sudden onset of horizontal binocular diplopia and stuttering of speech. On examination, bilateral exotropia (i.e. 'wall-eyed') was observed in the primary position. Attempted horizontal saccades revealed bilateral internuclear ophthalmoplegia; all consistent with the wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome. Convergence, vertical saccades and vestibular ocular reflexes were likewise impaired. Pupillary and levator palpebrae superioris functions were intact. Mild left-sided dysmetria, intention tremor and dysdiadochokinesia were elicited. Conspicuously, further characterization of the patient's history revealed that he had stuttered as a child, but it had resolved in adolescence. Brain MRI revealed an acute infarction of the mesencephalic and upper pontine tegmentum involving the periaqueductal gray region and the medial longitudinal fasciculus bilaterally with greater involvement of the left. Like the WEBINO syndrome, re-emergent developmental stuttering is a rare neurologic phenomenon. To our knowledge, this is the first case report of a mesencephalic and upper pontine infarction causing both syndromes. We discuss the pathobiological underpinnings of the WEBINO syndrome and neurogenic stuttering and in relationship to this unusual case.

KW - Bilateral internuclear ophthalmoplegia

KW - Midbrain

KW - Neuro-ophthalmology

KW - Neurogenic stuttering

KW - Periaqueductal gray

KW - Stuttering

KW - WEBINO syndrome

UR - http://www.scopus.com/inward/record.url?scp=84857997985&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857997985&partnerID=8YFLogxK

U2 - 10.1016/j.jns.2011.11.035

DO - 10.1016/j.jns.2011.11.035

M3 - Article

C2 - 22178081

AN - SCOPUS:84857997985

VL - 315

SP - 153

EP - 155

JO - Journal of the Neurological Sciences

JF - Journal of the Neurological Sciences

SN - 0022-510X

IS - 1-2

ER -