PMC9666881_01
(a) Straight gaze. (b) When attempting left gaze: note that the only possible
movement was the abduction in the left eye. (c) When attempting right gaze:
note that there were no movements at all in both eyes. (d) The whole face
with right LMN-type facial weakness.
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INO (adduction failure in the right eye with abducting nystagmus in the left eye) (Figure 1(a)-(c)). In addition, he had right LMN type VII nerve palsy (absence of wrinkling of right forehead, difficulty in closing right eyes, weakness of blowing of right cheek, deviation of mouth towards right side) (Figure 1(d)).
Diffusion-weighted MRI of the brainstem shows a tiny area of restricted
diffusion in the caudal right paramedian region of the pons.
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MRI of the brain confirmed an acute infarction in the right side of the pons near the midline (Figure 2).