Mild Bilateral Internuclear Ophthalmoplegia: The Diagnostic Role of the Vertical Posterior Canal Vestibulo-Ocular Reflex in Acute Brainstem Demyelination, a Clinical-Radiologic Correlation.

Background: The ocular signs of internuclear ophthalmoplegia (INO) with slow, restricted adduction of one eye and abduction nystagmus of the contralateral eye are easily recognized and have a high localizing/lateralizing value. However, subtle INO is difficult to diagnose. Recent reports identified novel vestibular abnormalities in unilateral and bilateral INO.

A system for telephone and secure email consultations, with automatic billing.

Doctors have traditionally provided medical advice during face-to-face consultations. A new remote consultation service has been developed based on an interactive voice response system and Internet-based technologies. If the doctor is unavailable, a return call can be requested at a mutually convenient time.