Rehabilitation practice for external ophthalmoplegia including voluntary training for patients with medial longitudinal fasciculus syndrome

Watabe T, Suzuki H, Abe M, Uchibori K, Senga K. Rehabilitation practice for external ophthalmoplegia including voluntary training for patients with medial longitudinal fasciculus syndrome. Jpn J Compr Rehabil Sci 2022; 13: 36‒40.Introduction: This report presents a case of external ophthalmoplegia caused by medial longitudinal fasciculus (MLF) syndrome. The patient underwent oculomotor rehabilitation by an occupational therapist during hospitalization and voluntary training supervised by the occupational therapist after discharge.Case: The patient presented with MLF syndrome due to bridge infarction. The left eye had a pronounced adduction disorder, and diplopia was observed in the median vision, resulting in severe discomfort in daily life. During the hospitalization, the patient underwent eye movement rehabilitation led by an occupational therapist that included pursuit, fixation, saccades, and convergence, and after discharge from the hospital, the patient underwent two sets of voluntary training for 10 min daily to induce pursuit, fixation, and convergence under the guidance of the occupational therapist. As a result, the angle of squint, degree of diplopia, and degree of inconvenience in daily life improved.Discussion: Eye movement rehabilitation, including voluntary training, improved external ophthalmoplegia.