Internuclear ophthalmoplegia — SCE Neurology MCQ
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Correct answer: D — The medial longitudinal fasciculus
The best answer is “The medial longitudinal fasciculus”. The medial longitudinal fasciculus synchronises horizontal gaze by linking abducens internuclear neurons to the contralateral medial-rectus subnucleus; damage produces internuclear ophthalmoplegia. The alternatives “The optic tract”, “The superior cerebellar peduncle”, “The corticobulbar tract”, “The dorsal longitudinal fasciculus” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.
Reference: NICE NG220 multiple sclerosis recommendations: https://www.nice.org.uk/guidance/ng220/chapter/Recommendations