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Related Experiment Videos

Isolated cranial nerve palsies in multiple sclerosis

F Thömke1, E Lensch, K Ringel

  • 1Department of Neurology, University of Mainz, Germany.

Journal of Neurology, Neurosurgery, and Psychiatry
|January 4, 1998
PubMed
Summary

Multiple sclerosis (MS) can present with isolated cranial nerve palsies. Magnetic resonance imaging (MRI) effectively detects dissemination in space, while electrophysiological testing identifies brainstem lesions in MS patients.

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Autoimmune diseases·2011

Area of Science:

  • Neurology
  • Neuroimmunology
  • Neuroimaging

Background:

  • Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
  • Cranial nerve palsies can be an early or isolated manifestation of MS, posing diagnostic challenges.

Purpose of the Study:

  • To investigate the diagnostic utility of neuroimaging and electrophysiological tests in multiple sclerosis patients presenting with isolated cranial nerve palsies.
  • To determine the sensitivity of Magnetic Resonance Imaging (MRI) and electrophysiological testing in documenting dissemination in space and brainstem lesions, respectively.

Main Methods:

  • Retrospective analysis of 24 patients with definite multiple sclerosis and isolated cranial nerve palsies over a 10-year period.
  • Evaluation of Magnetic Resonance Imaging (MRI) findings for brainstem lesions and dissemination in space.

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  • Assessment of electrophysiological tests including electro-oculography, masseter reflex, and blink reflex.

    • Main Results:

    • Cranial nerve palsies were the presenting sign in 14 patients and the sole sign of exacerbation in 10.
    • MRI confirmed brainstem lesions in 7 of 20 patients.
    • MRI documented dissemination in space in 11 of 14 patients presenting with isolated cranial nerve palsies; evoked potentials confirmed it in the remaining three.

    Conclusions:

    • In multiple sclerosis patients with isolated cranial nerve palsies, MRI is the most sensitive method for documenting dissemination in space.
    • Electrophysiological testing is the most sensitive method for disclosing brainstem lesions in this patient cohort.