The neuro-ophthalmology of multiple sclerosis

Frohman, Elliot M.; Frohman, Teresa C.; Zee, David S.; McColl, Roderick W; Galetta, Steven

doi:10.1016/s1474-4422(05)00992-0

Cited by 266 publications

(217 citation statements)

References 84 publications

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Section: Discussionunclassified

“…4 MS hastaları karşımıza görsel, duyusal ve okulomotor semptomları içeren çok çeşitli klinik tablolarla gelebilirler. 4,5 İzole kraniyal sinir felçleri ise MS'nin oldukça nadir görülen bulgularındandır. 6 Kraniyal sinir tutulumunun patogenezi tam olarak aydınlatılmamış olsa da birçok çalışmada beyin sapı demyelinizasyonu ile ilişkili olarak saptanmıştır.…”

Section: Discussionunclassified

“…Optik nörit, nistagmus, diplopi, internükleer oftalmopleji, göz hareketlerinde kısıtlılık gibi çeşitli oküler bulgular hastaların ilk başvuru semptomu olarak karşımıza çıkabilir. 4 MRG ise her zaman tanıyı koymakta yeterli değildir. 1 Erken tanı ve tedavi hastalığın seyri ve prognozu açısından büyük öneme sahiptir.…”

Section: Discussionunclassified

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A Case of Multiple Sclerosis Presented with 5th, 6th and 7th Cranial Nerve Paralysis

Bayar¹,

Şingar²,

Pınarcı³

et al. 2015

tjo

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A 36-year-old female patient was admitted to our clinic with complaints of numbness in hands, double vision, and inability to close her left eye. Her physical examination revealed horizontal diplopia, underactivity of the left lateral rectus muscle, left peripheral facial paralysis, and trigeminal sensorial neuropathy. The magnetic resonance imaging revealed hyperintense lesions, which were compatible with multiple sclerosis (MS). Therefore, systemic steroid treatment (1000 mg/day intravenous methylprednisolone for 5 days, 1 mg/ kg/day oral prednisolone, reduced slowly) was administered to the patient. Within five weeks, her symptoms were regressed, and no recurrence was observed during the follow-up period of 4 years. As this case proves, MS can present with cranial nerve palsies in addition to many other different neurological symptoms. Although 5 th nerve palsy is the most common cranial nerve palsy detected in MS patients, 7 th and 6 th nerve involvement are rarely reported in the literature. MS should always be considered in the differential diagnosis of cranial nerve palsies especially in young patients. (Turk J Ophthalmol 2015; 45: 81-3) Key Words: Multiple sclerosis, cranial nerve palsies, facial paralysis, diplopia Summary GirişMultiple skleroz (MS), daha çok 2.-4. dekadlar arasında görülen, santral sinir sistemini tutan kronik otoimmün demiyelinizan bir hastalıktır. 1 MS, birçok klinik çalışmanın gösterdiği gibi periferik sinir sistemi tutulumu ile de seyredebilir. 1 Klinikte MS farklı tiplerde karşımıza çıkmaktadır; bunlar subklinik MS, klinik izole sendrom, akut dissemine ensefalomiyelit, benign MS, tekrarlayan MS, primer ya da sekonder progresif MS ve optiko-spinal MS bunların birkaçıdır. 2 Retrobulber nörit, serebellar sendromlar, transvers myelit gibi birçok değişik tablo ile karşımıza gelebilir. 3 Beyin sapı tutulumu MS hastalarında sık görülse de başka semptom olmaksızın izole kraniyal sinir tutulumu oldukça nadirdir. 1 Birçok çalışmada MS hastalarında en sık görülen kraniyal sinir tutulumunun trigeminal sinir olduğu gösterilmiştir. 3 Bunu sırasıyla fasiyal, abdusens, okulomotor ve kohlear sinir tutulumları takip etmektedir. 1 Bu olgu sunumunda, eş zamanlı 5., 6. ve 7. sinir tutulumu ile başvuran ve MS tanısı alan klinikte nadir gözlemlediğimiz bir olgu tartışılacaktır.Otuz altı yaşında bayan hasta ellerde uyuşma, sol göz kapağını kapatamama, çift görme şikayetleriyle başvurdu. Horizontal diplopisi, sol dışa bakışında -1 kısıtlılığı, sol periferik fasiyal paralizisi ve 5. sinir dermatomuna uyan alanda his kaybı mevcuttu. Solda Bell fenomeni pozitifti. Hastanın manyetik rezonans (MR) görüntülemesinde multiple skleroz (MS) ile uyumlu hiperintens lezyonlar saptandı. Sistemik steroid tedavisi (IV puşe metilprednizolon 1000 mg/gün, 5 gün; ardından 1mg/kg oral tedrici azaltılarak) başlanan hastanın 5 hafta içerisinde fasiyal paralizisinin ve diplopisinin gerilediği, his kaybının düzeldiği izlendi. Hastanın 4 yıllık takibinde nüks izlenmedi. Bu olguda gördüğümüz gibi, MS karşımıza klasik periferik nöro...

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Section: Discussionunclassified

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A Case of Multiple Sclerosis Presented with 5th, 6th and 7th Cranial Nerve Paralysis

Bayar¹,

Şingar²,

Pınarcı³

et al. 2015

tjo

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“…Dentro de las primeras destacan las enfermedades del tejido conectivo, vasculitis, infecciones y sarcoidosis. Dentro de las segundas se incluyen la NMO y la neuritis óptica crónica-recurrente idiopática dependiente de corticoides [1][2][3][4][5] .…”

Section: Rev Chil Neuro-psiquiat 2014; 52 (2): 81-88unclassified

Neuritis óptica atípica en un adulto joven: un desafío diagnóstico

Triviño

Solanes

2014

Rev. chil. neuro-psiquiatr.

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“…Many cases are mild and are not identified during the screening examination. 8 Bilateral INO is often present, and INO may be combined with another deficit such as horizontal or vertical gaze palsy or skew. Disordered smooth pursuit and a corresponding abnormality of optokinetic nystagmus are found in more than 50% of patients with MS, according to Barnes and McDonald.…”

Section: How To Help Ms Patients With Ocular Problemsmentioning

confidence: 99%

Summary of Eye Examinations of 284 Patients with Multiple Sclerosis

J¹

2012

International Journal of MS Care

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The aim of this article is to report the findings of ocular examinations in a group of patients diagnosed with multiple sclerosis who were referred to the eye department of the Nationaal Multiple Sclerosis Centrum of Melsbroek, Belgium, from 2007 to 2010. Patients were evaluated by a single examiner, who noted visual acuity for distance, the state of the optic disks, oculomotor balance, and the presence of nystagmus, uveitis, trigeminal neuralgia, and facial palsy. The sample consisted of 284 adults born between 1920 and 1989: 111 males and 173 females. There were 51 patients with a corrected visual acuity in the better-seeing eye of less than 6/20. The optic nerve head was found to be normal in 245 eyes. Nystagmus was noted in 104 patients. Diplopia at distance was found to be present in 20 males, of whom 12 also had nystagmus, and in 31 females, of whom 13 also had nystagmus. Oscillopsia was present in 6 males and 11 females. In summary, most of the patients evaluated had sufficient visual function to allow performance of activities of daily living without help. A small number of patients had visual failure due to dysfunction of the visual sensory pathway and/or disturbances of oculomotor balance, often of a supranuclear origin, resulting in considerable disability. Int J MS Care. 2012;14:31-38.

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The neuro-ophthalmology of multiple sclerosis

Cited by 266 publications

References 84 publications

A Case of Multiple Sclerosis Presented with 5th, 6th and 7th Cranial Nerve Paralysis

A Case of Multiple Sclerosis Presented with 5th, 6th and 7th Cranial Nerve Paralysis

Neuritis óptica atípica en un adulto joven: un desafío diagnóstico

Summary of Eye Examinations of 284 Patients with Multiple Sclerosis

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