FP935 : WEBINO syndrome with bilateral cerebellar ataxia and facial dysesthesia: A rare presentation

Dr.SIVADARSHAN MURALIDHARAN, Dr.Kowsalya Akkayasamy, Dr.Mahesh Kumar

Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) is an uncommon disorder of ocular motility that possesses a unique spectrum of clinical findings, consisting of primary gaze exotropia, adduction impairment and nystagmus of the abducting eye. We report a 65 year old hypertensive who developed sudden onset of horizontal binocular diplopia and stuttering of speech and walking difficulty. On examination, bilateral exotropia (‘wall-eyed’) noted in the primary position. Attempted horizontal saccades revealed bilateral internuclear ophthalmoplegia; all consistent with the WEBINO syndrome. Pupillary and levator palpebrae superioris functions were intact. Bilateral dysmetria, intention tremor and dysdiadochokinesia were elicited. Diffusion weighted images of MRI Brain revealed acute infarcts involving both cerebellum, facial colliculi and MLF-PPRF region. WEBINO with bilateral ataxia is a rare association. Neurological examination is critical for evaluation of accurate ischemic area.