Unusual primary manifestations of multiple sclerosis: A case report

Abstract

Isolated cranial nerve involvement is rarely seen in multiple sclerosis patients. A 17-year-old female patient presented with complaints of numbness in the right half of her face, difficulty in chewing with the right jaw, having the right corner of her mouth drooping to the right, and blurring in both eyes. She had loss of sensation, left central facial paralysis, and frust monoparesis in the left arm in the right trigeminal nerve dermatome. Following systemic steroid treatment, her left central facial paralysis and chewing difficulties regressed, and loss of sensation improved. As in this case, MS may present with multiple instances of cranial nerve paralysis in addition to the involvement in the extremities. The association of the fifth and seventh nerve palsy in MS is rarely seen in the literature.