Internuclear Ophthalmoplegia EXPLAINED

Internuclear Ophthalmoplegia - hard to spell and even harder to understand. With the help of former president and famous MS patient Jed Barltlet, we'll be taking you through this tricky topic, one step at a time.
Conjugate horizontal gaze depends on the medial longitudinal fasciculus to ensure the oculomotor and abducens nerves remain on speaking terms.
But what if this heavily myelinated tract is blighted by a demyelinating disease such as multiple sclerosis? If the tract is damage, it can lead to failure of adduction, diplopia and the kind of gaze palsy just destined to show up in a postgraduate examination.
So let's get started!
MUSIC
1. Lobby Time
2. Upbeat Forever
Both courtesy of Incompetech.com
We don't own the rights to the West Wing but we wish we did. That show is great.
1. Longmore M, Wilkinson IB, Davidson EH Foulkes A, Mafi AR (2010). Neurology. In: Oxford Handbook of Clinical Medicine (Eight Edition). Oxford Press. pp 86 - 153
2. Ballinger A (2012). Neurology. In: Essentials of Kumar & Clark's Clinical Medicine (Fifth Edition). Saunders Elsevier. pp 407 - 504
3. Davies JER, Nijjer S (2014). Neurology. In: Kalra, PA. Essential Revision Notes for MRCP (Fourth Edition). PasTest. pp 1 - 64
4. Life in the Fast lane (2017). Internuclear Ophthalmoplegia

[@rayhanpitigala9297]

this was the greatest explanation i've ever heard. It was so easy to passivley learn and understand. thank you sir, form canada

[@arielmandelblum]

Absolutely agree!!

[@pariwhoop4935]

It's really amazing how you made such a seemingly difficult topic so incredibly easy to understand.

[@PedroHenrique-io6mj]

Welcome back, Zack :) Cheers from Brazil 😀

[@nikobiniaris1086]

it was sooo easy, I had no idea ! thanks so much !! You are the best

[@Jesse-pk2ue]

This video is the best thing that's happened to me during my opthalmology rotation - thanks!!

[@stevenshih191]

Thank you from a PT student. This was a very clear explanation. The visual helped a lot!

[@claireabailey]

Hands down best video I've seen today after 4.5 hours of study.

[@weelingkoh9098]

Best explanation ever thank you! - Saw an MS patient on the ward and I was trying to understand the concept. Really helped!

[@streemerz1]

Excellent work, keep doing these incredible videos!!!

[@Mustafa_KA]

You are amazing man .. welcome back and keep going 👍🏻👍🏻👍🏻

[@DrTheDarkNight]

This is amazing, great animation that's very well explained!

[@Got2beboss]

Finally understanding INO! Great and easy explanation, Thanks and greetings from Germany :)

[@aang7505]

absolutely incredible explanation! thank you for your time and effort creating this video!!!

[@arielmandelblum]

(currently 2nd semester medical student) -> I've been spending at least an hour getting nowhere trying to understand this, and other visual deficits. I found myself able to grasp the concept strongly on the first pass based on your explanation. Thank you!! Subscribed!

[@rozzarozza3250]

only you can make such a complicated concept so easy to understand, thanks a lot :)

[@dralvinjames]

Beautifully explained!!! Great effort.

[@Pxrdunk]

Love you ! Great Video man !! Thanks 🙏🏻♥️

OMG THIS VIDEO IS AMAZING! THANK YOU SO MUCH!

[@michaelbens8677]

Ive been trying to understand this concept, finally it makes sense. Much love

[@anilhari007]

th-cam.com/channels/IiTcGIr3odumo4QDyn3X-A.html?view_as=subscriber

[@christiandanielcastillomed206]

Oh man! I really had need this video. Thanks

[@proceedingg3502]

you literally made such a complicated concept so simple!!! thank you, more vids please :)

[@ZohaibHassanQ47]

it is a brilliant take, Thank You.

[@v_ronyca3244]

This is a great explanation! I needed the review! Thank you! :-)

[@pinapplekitty]

bless this instructor. makes so much sense. and definitely will be checking out the west wing

[@ruhammacristinapayano5374]

Uff this took me a while, thanks man. I GOT IT. SO fun and great animations!

[@miraclemelody9205]

The best explanation ever (over some 12 years as a medico)

[@angelaroxas7919]

Excellent! Thank you!

[@vxp999]

The best damn explantion fo INO!
I struglled for years trying understanding it, finaly its crystal clear!
Thank you so damn much!

[@mattiashartmann4203]

Amazing video, so easy to understand, thank you!!!

[@meenali6682]

by far the best explanation on the topic

[@halaalabboud480]

You’re the best, thanks 💗

[@melindiepretorius4632]

Such a great explanation, thank you!

[@SA-lr6tj]

Thank you so much, you have oversimplified it !

[@sameersami9304]

Excellent !

[@annatouskova3242]

Very good video, thank you.

[@exa-med5526]

great animations and explainations !!! excellent job guys

[@suprateekat5338]

Thanks so much! Understand this topic so much better because of your video

[@bogusdingus6634]

awesome explanation!

[@lumiahtisaari148]

My god, this was brilliantly done!! 👏👏

[@christinechilinga7608]

luv your vid! thank you!

[@kobilove]

u did ur big one explaining this. thank you

[@TheLeChannel]

Great job!

[@AllesGehritzt]

So damn good explained and illustrated. thank you very much

[@marialupu9015]

Thia was great! I FINALLY get it!🎉 Thank you!

[@draliciapoyser3081]

thank you so much its so clear now ,great video and explanation

[@poojamehta9471]

Wonderful video

[@raghadtv]

Amazing explanation!! ❤ thank you 

[@SmartFetus]

lol bro that was smoothly explained. you have a natural talent for this. hats off, my paces exam is in a month

[@gilliang.691]

such a great video!

[@shewomanbabe]

Excellent!!

[@danimartin2397]

Thank you, bro!! It's been really useful! Thanks from Bcn

[@moizazahid8970]

this is such a wonderful explanation. thank you so very much dude

[@M1ntt806]

Legendary explanation my man. Absolutely loved it xD

[@akankshatiwari2060]

Awesome video brother.

[@josy4767]

This made such a tricky topic to understand so clear

[@tusharghosh644]

Awesome!

[@HJSZ7]

Thanks, this was very helpful.

[@hafsashehzad6708]

This was so helpful!!!!!

[@Gr4ceful4life]

thank you for your video

[@ayak.abdalani484]

the amazing, gorgeous, speechless explanation I've ever found ☕

[@yomiimasogie4722]

Bravo. Been trying to understand INO but reads then forget but watching these wow I will never forget it. 👍👍👍

[@ratkanitdamrong7120]

Thank you for your vdo. It’s easy to watch and understand.

[@laibaabid7448]

WOAH! THUMBS UP. YOU MADE THIS SO EASY

[@dingdong436.]

Thank you very much!!❤

[@charlesaugustine3695]

So easily explained 🙏

[@natalieweller6286]

Brilliant I finally understand that!

[@scullyplt]

Brilliant !

[@rawan7215]

Thanks for the explanation, it was very helpful

[@pauljaison2046]

Thank you,it was perfect clear

[@victorpena7450]

Thank you so much I finally get this

[@dr.naveedullahkhan811]

I simply love the way you explained it😄😄

[@nim6419]

Brilliance at its very best!! 😉 thank you

[@badariahaminudin2087]

Thank youu so much !! The animation is very great i could finally understand it 👍🏻☺️

[@evapianista2835]

You are truley amazing

[@Mrluckyjo]

this guy is a legend! and a looker too!

[@Zahra-Mousavi01]

Thank you!

[@iloveu975]

Thank you for such a great video!

[@anilhari007]

th-cam.com/channels/IiTcGIr3odumo4QDyn3X-A.html?view_as=subscriber

[@digitalbeatz8016]

Thanks a lot ! Was struggling to understand it!

[@onadipeoluwatoyin7826]

brilliant bro ...thank you!!

[@maysoonattar2746]

Amazing explanation!!!!

[@idim9248]

excellent animation and explanation. thanks

[@kokocipher]

thanks so much for explaining such a insanely complicated topic seem so easy

[@shkokurda2098]

Dude i love your presentation style

[@Thechirimbola]

your animations are amazing. Keep going pls

[@wnapholi]

Really good. Thank u.

[@dr_ksparejiya]

This really helped man... Thanks 🙌

[@dianecousin2053]

Thank you so much for this video, it's so clear now :)

[@tomsflaherty]

Good effort. I think the drawing could be a little bit easier to understand if you put the CN VI nuclei at the very top of the screen, followed by MLF in the middle, followed by CN III nuclei lower down, followed by eyes at the bottom. I would love to copy and paste you an image from a text book but can't in this comment section. The way you currently have it means that you are following nerve signals in several different directions (CN VI to CN III is towards the top of the screen, but then CN III to medial rectus is towards the bottom of the screen). If you lay it out as I suggest, everything goes from top of the screen to the bottom and it's MUCH easier to see why you get the medial recuts palsy (it will actually look like the contralateral MLF is blocking the signal coming to it from the nucleus of CN VI which then means the contralateral medial rectus muscle doesn't function properly - which is in effect what happens). I love that people are praising you below, and I hope you take this as constructive criticism, because I love what you guys are intending to do and I'm only saying this to help you improve.

[@ViVenMoksha]

thank you for this explanation. i was only able to piece the conduction orders correctly after reading this or else i couldn't have understood at all.

[@alankrita2010856]

If there were a wow react option available I would definitely click that. Lovely animation. Couldn't have understood better than this. Thanks.

[@salet89]

Awesome!!! thank you!!!

[@tiptoe609]

I enjoyed it while learning from it

[@DrBrandonBeaber]

Excellent video. I was planning to do my own version of this, but this video would be touch to beat.

[@arkiles2]

thank you so much

[@mimonabrazily6919]

Thank u finally I understand it 😩❤️

[@sweetdoc1472]

That was amazing

[@vishnukanilkumar3849]

Perfect one

[@Deepblackice]

awesome man! thanks heaps for this
learning this from Australia

[@user-yg1dj8os3t]

Awesome explanation 😊

[@hm-eo2gy]

Great explanation 🫡🫡🫡❤️❤️❤️❤️

[@hrickayan8257]

Thanks a lot.