Mesencephalic Cleft: Case Report and Review of the Literature

A 44 year old male was referred from another physician with features of bilateral internuclear ophthalmoplegia, ataxia and facial weakness. Symptoms has been slowly evolving over 7 years and previous investigation was unrewarding. He had previously been diagnosed as suffering from multiple sclerosis, but steroids had had no effect. An MRI scan showed a mesencephalic cleft with minor abnormalities of the fourth ventricle which was considered to explain the clinical features after review of the literature.