Parinaud SyndromeiA Rare Relapse in Multiple Sclerosis

摘要

Parinaud syndrome is a disorder of eye movements due to lesions affecting the dorsal midbrain. Surprisingly, it is a very rare sign in multiple sclerosis. Herein the authors report a patient who presented with Parinaud syndrome in the context of multiple sclerosis. The initial multiple sclerosis symptoms occurred when he was 23 years of age consisting of sudden-onset action tremor. Seven years later, the patient noticed diplopia and was found to have bilateral internuclear ophthalmoplegia and Parinaud syndrome. Magnetic resonance imaging (MRI) scans showed T2/ FLAIR hyperintense lesions in the white matter of both hemispheres, cerebral peduncle, midbrain, pons, and spinal cord, compatible with demyelination. Others diseases mimicking multiple sclerosis were excluded.