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Updated: Dec 20, 2025
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Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
Published on: April 14, 2014
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A 26-Year-Old Woman With Diplopia and Nystagmus
William J Anderson1, Aseem Sharma, Miguel A Guzman
1Departments of Ophthalmology (WJA, MAG, SMC), Pathology (MAG), and Neurology (SMC), Saint Louis University School of Medicine, St. Louis, Missouri; and Department of Radiology (AS), Washington University School of Medicine, St. Louis, Missouri.
Summary
A young woman with a year of neurological symptoms was diagnosed with a rare brain tumor after imaging suggested infection. This case highlights the importance of considering tumors in differential diagnoses for complex neurological presentations.
Area of Science:
- Neuro-oncology
- Neurology
- Ophthalmology
Background:
- A 26-year-old woman presented with subtle neurological deficits including sixth nerve palsy and nystagmus.
- She reported a year of horizontal diplopia, right-sided weakness, and poor balance.
Observation:
- Brain and spinal MRI revealed multiple cystic lesions with variable enhancement in the posterior fossa and cervical spinal cord.
- Initial imaging raised suspicion for infectious etiologies like neurocysticercosis, as well as primary or metastatic tumors.
Findings:
- Differential diagnosis considered tumor location and imaging characteristics to distinguish between infectious and neoplastic processes.
- A brain biopsy confirmed the diagnosis of a rosette-forming glioneuronal tumor (RGNT).
Implications:
- This case underscores the importance of comprehensive diagnostic evaluation for unexplained neurological symptoms.
- It highlights RGNTs as a rare but critical consideration in the differential diagnosis of cystic brain lesions.
- Accurate diagnosis through biopsy is crucial for appropriate management and treatment of such tumors.
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