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Case Report: Transient Dorsal Midbrain Syndrome as the Initial Presentation of Multiple Sclerosis

Case Report: Transient Dorsal Midbrain Syndrome as the Initial Presentation of Multiple Sclerosis SIGNIFICANCE Prompt neuroimaging is important to identify multiple sclerosis lesions in the appropriate clinical setting. However, despite a normal brain MRI finding, a diagnosis of multiple sclerosis still must be considered in cases of dorsal midbrain syndrome, even if it is transient. PURPOSE The purpose of this case report is to present a patient with a transient presentation of dorsal midbrain syndrome, resolving within 1 week of initial symptoms, which was ultimately attributed to multiple sclerosis in the setting of a normal enhanced brain MRI study. CASE REPORT A 33-year-old man with new-onset visual complaints was found to have upgaze paresis, eyelid retraction, and pupillary light-near dissociation suggestive of dorsal midbrain syndrome. Within days, enhanced brain MRI was completed and showed a normal finding, and the clinical features of dorsal midbrain syndrome had resolved. Subsequent spine imaging and lumbar puncture lead to an ultimate diagnosis of multiple sclerosis. CONCLUSIONS There have been a few reported cases of dorsal midbrain syndrome as the presenting feature of multiple sclerosis. This case is unique because it reports a transient presentation of dorsal midbrain syndrome, documented to have resolved only days after initial presentation, which was ultimately attributed to multiple sclerosis. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Optometry and Vision Science Wolters Kluwer Health

Case Report: Transient Dorsal Midbrain Syndrome as the Initial Presentation of Multiple Sclerosis

Malloy, Kelly A.; Draper, Erin M.; Maglione, Ashley Kay
Optometry and Vision Science , Volume Publish Ahead of Print – Apr 1, 2020
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References (5)

Publisher
Wolters Kluwer Health
Copyright
Copyright © 2019 American Academy of Optometry
ISSN
1040-5488
eISSN
1538-9235
DOI
10.1097/OPX.0000000000001413
Publisher site
See Article on Publisher Site

Abstract

SIGNIFICANCE Prompt neuroimaging is important to identify multiple sclerosis lesions in the appropriate clinical setting. However, despite a normal brain MRI finding, a diagnosis of multiple sclerosis still must be considered in cases of dorsal midbrain syndrome, even if it is transient. PURPOSE The purpose of this case report is to present a patient with a transient presentation of dorsal midbrain syndrome, resolving within 1 week of initial symptoms, which was ultimately attributed to multiple sclerosis in the setting of a normal enhanced brain MRI study. CASE REPORT A 33-year-old man with new-onset visual complaints was found to have upgaze paresis, eyelid retraction, and pupillary light-near dissociation suggestive of dorsal midbrain syndrome. Within days, enhanced brain MRI was completed and showed a normal finding, and the clinical features of dorsal midbrain syndrome had resolved. Subsequent spine imaging and lumbar puncture lead to an ultimate diagnosis of multiple sclerosis. CONCLUSIONS There have been a few reported cases of dorsal midbrain syndrome as the presenting feature of multiple sclerosis. This case is unique because it reports a transient presentation of dorsal midbrain syndrome, documented to have resolved only days after initial presentation, which was ultimately attributed to multiple sclerosis.

Journal

Optometry and Vision Science – Wolters Kluwer Health

Published: Apr 1, 2020

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