Teaching NeuroImage: Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) from midbrain infarction

A 78-year-old man with hypertension and diabetes was referred because of 3 days of diplopia and ophthalmoplegia. Neurologic examination disclosed exotropia of both eyes (wall-eyed) and bilateral internuclear ophthalmoplegia (WEBINO) with impaired convergence (figure, A).1 Vertical saccades and smooth pursuit were also limited, but improved during the …