Brain MRI in Multiple Sclerosis (Guest Lecture)

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Identifier Wray_Case933-1_PPT
Title Brain MRI in Multiple Sclerosis (Guest Lecture)
Creator Anne G. Osborn, MD
Affiliation Distinguished Professor of Radiology, Department of Radiology, University of Utah
Subject Bilateral Internuclear Ophthalmoplegia; Abducting Nystagmus; Normal Convergence; Gaze Evoked Upbeat Nystagmus; Gaze Evoked Downbeat Nystagmus; Saccadic Dysmetria; Multiple Sclerosis; Horizontal Saccadic Dysmetria
Description The patient is a 25 year old woman who was in excellent health until 4 days prior to admission when she noted blurred vision and horizontal double vision on lateral gaze to right and left. Past History: Negative for strabismus as a child. No previous episodes of transient neurological symptoms. Family History: Negative for neurological diseases. Neuro-ophthalmological Examination Visual acuity 20/20 OU Visual fields, pupils and fundus examination normal. Ocular Motility: Paresis of adduction of the right eye on gaze left Abducting nystagmus of the left eye on gaze left. Paresis of adduction of the left eye on gaze right Abducting nystagmus of the right eye on gaze right Normal convergence Upbeat nystagmus on upgaze Downbeat nystagmus on downgaze Saccadic dysmetria Hypermetria of the adducting eye Hypometria of the abducting eye Diagnosis: Bilateral internuclear ophthalmoplegia (INO) Saccadic dysmetria Brain CT with and without contrast normal. Prognosis: On follow-up six weeks later the eye movements were normal. Diagnosis: Multiple Sclerosis (MS) The diagnosis of MS was suspected and discussed with the patient and her parents. The rapid recovery of her motility disorder was consistent with the diagnosis. MS is the commonest cause of a bilateral internuclear ophthalmoplegia in a young adult. Brainstem infarction is the commonest cause of a unilateral internuclear ophthalmoplegia in middle aged and elderly adults. A bilateral internuclear ophthalmoplegia in a child raises the possibility of a 4th ventricle tumor. (ID163-6). The patient is a little boy who presented with a bilateral INO and was found to have a medulloblastoma. See also: http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/94
Date 2002
Language eng
Format application/pdf
Format Creation Microsoft PowerPoint
Type Text
Relation is Part of 933-1
Collection Neuro-Ophthalmology Virtual Education Library: NOVEL https://NOVEL.utah.edu
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 2002. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6100btq
Setname ehsl_novel_novel
ID 186804
Reference URL https://collections.lib.utah.edu/ark:/87278/s6100btq
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