Peripheral Third Cranial Nerve Enhancement in Multiple Sclerosis

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2003 Aug 15

PMID 12917135

Citations 3

Authors

M Tariq Bhatti

Ilona M Schmalfuss

Lorna S Williams

Ronald G Quisling

Affiliations

Soon will be listed here.

Abstract

Cranial nerve III dysfunction in multiple sclerosis (MS) is uncommon. Seven cases of isolated cranial nerve III paresis associated with MS have been reported in the English-language literature. MR imaging was obtained in five cases demonstrating lesions within the midbrain. We present the detailed clinical and MR imaging findings of a young woman with MS and an isolated, painful pupil involving complete left cranial nerve III palsy. Initial MR imaging showed isolated enhancement of the cisternal portion of the cranial nerve III, suggesting that peripheral nervous system involvement may develop as part of the disease process in some patients with MS.

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References

Ormerod I, Waddy H, Kermode A, Murray N, Thomas P . Involvement of the central nervous system in chronic inflammatory demyelinating polyneuropathy: a clinical, electrophysiological and magnetic resonance imaging study. J Neurol Neurosurg Psychiatry. 1990; 53(9):789-93. PMC: 1014259. DOI: 10.1136/jnnp.53.9.789. View

Kalman B, Lublin F . Spectrum and classification of inflammatory demyelinating diseases of the central nervous system. Curr Neurol Neurosci Rep. 2002; 1(3):249-56. DOI: 10.1007/s11910-001-0027-5. View

Rubin M, Karpati G, Carpenter S . Combined central and peripheral myelinopathy. Neurology. 1987; 37(8):1287-90. DOI: 10.1212/wnl.37.8.1287. View

Hosoya T, Adachi M, Yamaguchi K, Kato T, Sugai Y . Abducens nerve enhancement demonstrated by multiplanar reconstruction of contrast-enhanced three-dimensional MRI. Neuroradiology. 2001; 43(4):295-301. DOI: 10.1007/s002340000338. View

Poser C . The peripheral nervous system in multiple sclerosis. A review and pathogenetic hypothesis. J Neurol Sci. 1987; 79(1-2):83-90. DOI: 10.1016/0022-510x(87)90262-0. View

Nagaoka U, Kato T, Kurita K, Arawaka S, Hosoya T, Yuki N . Cranial nerve enhancement on three-dimensional MRI in Miller Fisher syndrome. Neurology. 1996; 47(6):1601-2. DOI: 10.1212/wnl.47.6.1601. View

Thomke F, Lensch E, Ringel K, Hopf H . Isolated cranial nerve palsies in multiple sclerosis. J Neurol Neurosurg Psychiatry. 1998; 63(5):682-5. PMC: 2169805. DOI: 10.1136/jnnp.63.5.682. View

Mark A, Casselman J, Brown D, Sanchez J, KOLSKY M, Larsen 3rd T . Ophthalmoplegic migraine: reversible enhancement and thickening of the cisternal segment of the oculomotor nerve on contrast-enhanced MR images. AJNR Am J Neuroradiol. 1999; 19(10):1887-91. PMC: 8337745. View

Uitti R, Rajput A . Multiple sclerosis presenting as isolated oculomotor nerve palsy. Can J Neurol Sci. 1986; 13(3):270-2. DOI: 10.1017/s0317167100036428. View

10.

Berger T, Weerth S, Kojima K, Linington C, Wekerle H, Lassmann H . Experimental autoimmune encephalomyelitis: the antigen specificity of T lymphocytes determines the topography of lesions in the central and peripheral nervous system. Lab Invest. 1997; 76(3):355-64. View

11.

Arnold D, Matthews P . MRI in the diagnosis and management of multiple sclerosis. Neurology. 2002; 58(8 Suppl 4):S23-31. DOI: 10.1212/wnl.58.8_suppl_4.s23. View

12.

Ksiazek S, Repka M, Maguire A, Harbour R, Savino P, Miller N . Divisional oculomotor nerve paresis caused by intrinsic brainstem disease. Ann Neurol. 1989; 26(6):714-8. DOI: 10.1002/ana.410260605. View

13.

Lee A, Tang R, Wong G, Schiffman J, Singh S . Isolated inferior rectus muscle palsy resulting from a nuclear third nerve lesion as the initial manifestation of multiple sclerosis. J Neuroophthalmol. 2000; 20(4):246-7. View

14.

Waxman S . Peripheral nerve abnormalities in multiple sclerosis. Muscle Nerve. 1993; 16(1):1-5. DOI: 10.1002/mus.880160102. View

15.

Wingerchuk D, Lucchinetti C, Noseworthy J . Multiple sclerosis: current pathophysiological concepts. Lab Invest. 2001; 81(3):263-81. DOI: 10.1038/labinvest.3780235. View

16.

Richards B, Jones Jr F, Younge B . Causes and prognosis in 4,278 cases of paralysis of the oculomotor, trochlear, and abducens cranial nerves. Am J Ophthalmol. 1992; 113(5):489-96. DOI: 10.1016/s0002-9394(14)74718-x. View

17.

Jacobson D, Moster M, Eggenberger E, Galetta S, Liu G . Isolated trochlear nerve palsy in patients with multiple sclerosis. Neurology. 1999; 53(4):877-9. DOI: 10.1212/wnl.53.4.877. View

18.

Newman N, Lessell S . Isolated pupil-sparing third-nerve palsy as the presenting sign of multiple sclerosis. Arch Neurol. 1990; 47(7):817-8. DOI: 10.1001/archneur.1990.00530070117021. View

19.

Mark A, Blake P, Atlas S, ROSS M, Brown D, KOLSKY M . Gd-DTPA enhancement of the cisternal portion of the oculomotor nerve on MR imaging. AJNR Am J Neuroradiol. 1992; 13(5):1463-70. PMC: 8335232. View

20.

Desai H, MACFADYEN D . Multiple sclerosis presenting as third nerve palsy. Can J Neurol Sci. 1987; 14(2):178-9. View