Homonymous hemianopsia as the initial manifestation of multiple sclerosis.
A 28-year-old male patient in good health with no previous neurologic or ophthalmoscopic abnormalities developed right homonymous hemianopsia. Magnetic resonance (MR) imaging demonstrated bilateral high-signal suprageniculate lesions. The lesion located in the left parieto-occipital area was compatible with the field defect observed. Oligoclonal bands were present in the cerebrospinal fluid. Testing of visual-evoked potentials revealed increased latencies in both eyes. The patient was given 1 g/day intravenous methylprednisolone for 3 days. The visual fields, as determined by automated static perimetry, recovered completely in 2 weeks. Follow-up MR imaging at 1 month showed no change compared to baseline. Seven months after the initial attack he suffered right internuclear ophthalmoplegia, which resolved spontaneously within 1 week. Based on the clinical and radiologic findings, the final diagnosis was made as clinically definite multiple sclerosis (MS). This patient represents a rare case of MS presenting first with homonymous hemianopsia.
Gündüz
K
K
Keçiören Numune State Hospital, Ankara, Turkey.
Cansu
K
K
Bulduklar
S
S
Saatçi
I
I
D000328:Adult; D005074:Evoked Potentials, Visual; D005938:Glucocorticoids / Q000627:therapeutic use; D006423:Hemianopsia / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000188:drug therapy; D009778:Occipital Lobe / Q000473:pathology*; D010296:Parietal Lobe / Q000473:pathology*; D014794:Visual Fields
D005938:Glucocorticoids; D008775:Methylprednisolone