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Multiple sclerosis: a consideration in acute cranial nerve palsies
1Department of Otolaryngology, Sunnybrook Health Science Centre, University of Toronto, Canada.
The American Journal of Otology
|September 26, 1997
Summary
Multiple sclerosis (MS) can present as multiple acute cranial nerve palsies. Early diagnosis and treatment of MS brain stem involvement are crucial to reduce patient morbidity.
Area of Science:
- Neurology
- Neuroimmunology
Background:
- Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
- Cranial nerve palsies can be an early or presenting symptom of MS.
Observation:
- A case of MS presenting with audiovestibular and facial nerve deficits is reported.
- A literature review identified brain stem manifestations of MS.
Findings:
- Brain stem involvement occurs as the presenting feature in up to 15% of MS cases.
- Cranial nerve palsies, particularly those affecting the brain stem, are significant presenting symptoms of MS.
Implications:
- Heightened awareness of MS as a cause of cranial nerve palsies is necessary for prompt diagnosis.
- Early diagnosis and treatment of MS presenting with brain stem symptoms can reduce neurological morbidity.
- Maintaining a high index of suspicion for MS is vital to prevent misdiagnosis.