Abstract
Six months after the onset of visual loss a 23-year-old male patient with Leber's optic neuropathy associated with a mitochondrial DNA mutation developed brain stem involvement with Parinaud's syndrome and oculopalatal myoclonus. Magnetic resonance imaging (MRI) revealed a high signal area in the brain stem, corresponding to a hypodense area in the CT scan that did not show contrast enhancement. Distinct diminution but not complete remission of the MRI findings was found in the 5-year follow-up, which was not accompanied by clinical improvement. Although the MRI findings were compatible with a demyelinating lesion, neither extensive evoked potential studies nor spinal fluid examination supported this.
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Paulus, W., Straube, A., Bauer, W. et al. Central nervous system involvement in Leber's optic neuropathy. J Neurol 240, 251–253 (1993). https://doi.org/10.1007/BF00818714
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DOI: https://doi.org/10.1007/BF00818714