Abnormal electrophysiological findings and MRI established brainstem lesions in 24 patients with multiple sclerosis and isolated cranial nerve palsies as the presenting sign or the sole clinical manifestation of an exacerbation
| Bout | No | Age | Sex | Nerve | Abnormal electrophysiological and MRI findings | ||||
|---|---|---|---|---|---|---|---|---|---|
| 1st | 1 | 50 | F | 3rd | EOG | Contralaterally slowed adduction saccades (n) | |||
| MR | Ipsilateral | 7.9 | 8.7 | 9.6 ms | |||||
| Contralateral | 9.0 | 9.3 | 9.5 ms | ||||||
| MRI | Periaqueductal midbrain lesion | ||||||||
| 1st | 2 | 30 | M | 4th | MR | Ipsilateral | 7.2 | 7.6 ms | |
| Contralateral | 7.7 | 7.9 ms | |||||||
| 1st | 3 | 30 | F | 6th | EOG | Ipsilateral vestibular paresis (n) | |||
| 1st | 4 | 29 | M | 6th | EOG | Contraversive directional preponderance (n) | |||
| 1st | 5 | 36 | M | 6th | EOG | Saccadic pursuit eye movements (i) | |||
| Optokinetic nystagmus: reduced gain of contraversive following eye movements (n) | |||||||||
| MRI | Ipsilateral pontine lesion | ||||||||
| 1st | 6 | 33 | F | 6th | EOG | Contralaterally slowed abduction an adduction saccades (n) | |||
| Optokinetic nystagmus: reduced gain of contraversive following eye movements (n) | |||||||||
| MRI | Ipsilateral pontine lesion | ||||||||
| 1st | 7 | 19 | F | 6th | EOG | Contralaterally slowed abduction saccades (n) | |||
| Hypometric contraversive saccades (i) | |||||||||
| SEP | Unilaterally delayed P40 | ||||||||
| 1st | 8 | 25 | F | 6th | EOG | Contraversive directional preponderance (n) | |||
| MRI | Ipsilateral pontine lesion | ||||||||
| 1st | 9 | 23 | M | 7th | EOG | Saccadic pursuit eye movements (n) | |||
| 1st | 10 | 24 | F | 7th | VEP | Unilateral delay | |||
| 1st | 11 | 30 | M | 7th | VEP | Unilateral delay | |||
| 1st | 12 | 24 | F | 8th vest | EOG | Ipsilaterally slowed adduction saccades (n) | |||
| 1st | 13 | 25 | F | 8th vest | EOG | Optokinetic nystagmus: reduced gain of ipsiversive following eye movements (n) | |||
| MR | Ipsilateral | 7.8 | 5.3 ms | ||||||
| Contralateral | 7.1 | 5.4 ms | |||||||
| 1st | 14 | 43 | F | 8th vest | MR | Ipsilateral | 7.2 | 5.9 ms | |
| Contralateral | 7.7 | 7.0 ms | |||||||
| 2nd | 15 | 24 | F | 6th | EOG | Contralaterally slowed abduction saccades (n) | |||
| 2nd | 16 | 28 | F | 6th | EOG | Contralaterally slowed abduction saccades (n) | |||
| MR | Ipsilateral | 7.6 | 7.5 ms | ||||||
| Contralateral | 8.2 | 9.0 ms | |||||||
| MRI | Ipsilateral pontine lesion | ||||||||
| 2nd | 17 | 30 | F | 6th | EOG | Contraversive directional preponderance (n) | |||
| Ipsiversive saccadic pursuit eye movements (i) | |||||||||
| 2nd | 18 | 33 | F | 6th | EOG | Contralaterally slowed abduction saccades (n) | |||
| Saccadic pursuit eye movements (i) | |||||||||
| MR | Ipsilateral | 7.4 | 7.9 ms | ||||||
| Contralateral | 6.6 | 7.1 ms | |||||||
| 2nd | 19 | 28 | F | 8th vest | MR | Ipsilateral | 7.4 ms | ||
| Contralateral | 6.5 ms | ||||||||
| 2nd | 20 | 30 | M | 8th vest | MRI | Ipsilateral pontine lesion | |||
| 3rd | 21 | 32 | F | 6th | EOG | Ipsiversive saccadic pursuit eye movements (i) | |||
| Abnormal fixation suppression of ipsiversive nystagmus (n) | |||||||||
| 3rd | 22 | 36 | F | 6th | EOG | Saccadic pursuit eye movements (i) | |||
| Slowed contraversive saccades (n) | |||||||||
| BR-R1 | Ipsilateral | 11.5 | 11.6 ms | ||||||
| Contralateral | 13.5 | 12.1 ms | |||||||
| 3rd | 23 | 32 | F | 8th coch | EOG | Ipsilaterally slowed abduction saccades (n) | |||
| Optokinetic nystagmus: reduced gain of following eye movements in both directions (i) | |||||||||
| 3rd | 24 | 37 | F | 8th vest | MRI | Ipsilateral pontine lesion | |||
8th vest = vestibular portion of the 8th nerve; 8th coch = cochlear portion of the 8th nerve; EOG = electro-oculography; MR = masseter reflex; BR-R1 = R1 component of the blink reflex; VEP = visual evoked potentials; SEP = somatosensory evoked potentials; (n) = normalisation; (i) = improvement.