From heart to brain: Bilateral internuclear ophthalmoplegia following angioplasty

Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) is a rare neuro-ophthalmological condition caused by bilateral medial longitudinal fasciculus (MLF) lesions. We report a 65-year-old female presenting with binocular diplopia and giddiness following coronary angioplasty. Clinical examination revealed bilateral adduction restriction, exotropia, and convergence insufficiency. Magnetic resonance imaging confirmed an acute lacunar infarct in the dorsal midbrain involving the MLF. The patient was managed conservatively with dual antiplatelet therapy. This case underscores the importance of early recognition and imaging in post-angioplasty neurological complications, highlighting the clinical implications of brainstem ischemia and its role in the pathogenesis of rare neuro-ophthalmic syndromes like WEBINO.