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Isolated trochlear nerve palsy: an atypical presentation of multiple sclerosis
Marta Carrera Tarrés1, Josep Visa Nasarre1, Julia Nash Monsó1
1Pediatric Ophthalmology and Strabismus Department, Parc Taulí Hospital, Autonomous University of Barcelona, Barcelona, Spain.
Summary
A woman with vertical double vision and hand numbness was diagnosed with multiple sclerosis (MS). Early immunotherapy prevented further relapses, highlighting the importance of prompt diagnosis and treatment for this neurological condition.
Area of Science:
- Neurology
- Neuroimmunology
- Ophthalmology
Background:
- Trochlear nerve palsy can present with vertical diplopia, potentially indicating underlying neurological conditions.
- Paresthesia in the extremities may be an early symptom of demyelinating diseases.
Observation:
- A 31-year-old female presented with acute vertical diplopia and a history of hand paresthesia.
- Initial CT scan ruled out acute intracranial pathology.
- MRI revealed multiple white matter lesions consistent with a demyelinating process.
Findings:
- The patient was diagnosed with relapsing-remitting multiple sclerosis (MS).
- Treatment with immunotherapy was initiated promptly.
- No further MS exacerbations were observed following treatment.
Implications:
- This case underscores the significance of thorough neurological evaluation for symptoms like diplopia and paresthesia.
- Early diagnosis and initiation of immunotherapy in relapsing-remitting MS can effectively manage disease activity and prevent relapses.
- Prompt treatment can significantly improve patient outcomes and quality of life in MS patients.
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