Two Multiple Sclerosis Relapses Affecting the Left Pontine-Mesencephalic Transition and Later the Right Mid Pons, With Distinct Eye Movement Abnormalities - The Importance Of Semiology Above Medical Imaging: Case Report

• Main Authors: Paulo Afonso Mei, Francisco Saulo S.C. Tavares
• Format: Article
• Language: English
• Published: European Medical Journal 2020-09-01
• Series: EMJ Radiology
• Subjects: nternuclear ophthalmoplegia; multiple sclerosis (ms); normal appearing white matter (nawm); semiology; throclear nerve palsy
• Online Access: https://www.emjreviews.com/radiology/article/two-multiple-sclerosis-relapses-affecting-the-left-pontine-mesencephalic-transition-and-later-the-right-mid-pons-with-distinct-eye-movement-abnormalities-the-importance-of-semiology-above-medical-i/
• ISSN: 2633-9978

The authors report the case of a 22-year-old female patient who presented with two distinct relapses of multiple sclerosis. The first was a lesion in the dorsal paramedian pontine area to the left, and the second, not visible in the MRI but presumably affecting the right medial longitudinal fasciculus, in the pons. In both cases, the semiology was unquestionable and compatible to the proposed areas of demyelination, with the patient fully recovering her eye movements after pulses of methylprednisolone.