title: Involvement of peripheral III nerve in multiple sclerosis patient: Report of a new case and discussion of the underlying mechanism.
abstract: Multiple sclerosis (MS) is a chronic disorder that affects the central nervous system myelin. However, a few radiological cases have documented an involvement of peripheral cranial nerves, within the subarachnoid space, in MS patients. We report the case of a 36-year-old female with a history of relapsing-remitting (RR) MS who consulted for a subacute complete paralysis of the right III nerve. Magnetic resonance imaging (MRI) examination showed enhancement and thickening of the cisternal right III nerve, in continuity with a linear, mesencephalic, acute demyelinating lesion. Radiological involvement of the cisternal part of III nerve has been reported only once in MS patients. Radiological involvement of the cisternal part of V nerve occurs more frequently, in almost 3% of MS patients. In both situations, the presence of a central demyelinating lesion, in continuity with the enhancement of the peripheral nerve, suggests that peripheral nerve damage is a secondary process, rather than a primary target of demyelination.
authors.affiliation: AP-HP, Service de Neuroradiologie Diagnostique et Fonctionnelle, Hôpital de la Pitié-Salpêtrière, Paris, France.
authors.forename: Natalia
authors.initials: N
authors.lastname: Shor
authors.affiliation: AP-HP, Service de Neurologie, Hôpital de la Pitié-Salpêtrière, Paris, France.
authors.forename: Maria Del Mar
authors.initials: MD
authors.lastname: Amador
authors.affiliation: AP-HP, Service de Neuroradiologie Diagnostique et Fonctionnelle, Hôpital de la Pitié-Salpêtrière, Paris, France/Inserm U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Inria Paris-Rocquencourt, Paris, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Dormont
authors.affiliation: AP-HP, Service de Neurologie, Hôpital de la Pitié-Salpêtrière, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lubetzki
authors.affiliation: AP-HP, Service de Neuroradiologie Diagnostique et Fonctionnelle, Hôpital de la Pitié-Salpêtrière, Paris, France/Inserm U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Inria Paris-Rocquencourt, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Bertrand
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis / Q000473:pathology*; D009186:Myelin Sheath / Q000473:pathology*; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000473:pathology*; D014276:Trigeminal Nerve / Q000473:pathology*
keywords: Multiple sclerosis; cisternal enhancement; cranial nerve; peripheral neuropathy