A Case of Eight-and-a-Half-Syndrome as a Presenting Manifestation of Late Onset Multiple Sclerosis

Abstract

We describe a 74-year-old woman presenting with right Internuclear Ophtalmoplegia (INO), horizontal gaze palsy and ipsilateral peripheral facial nerve palsy known as eight-and-a-half-syndrome. MRI and CSF findings led to diagnosis of Clinically Isolated Syndrome (CIS). One month later, the patient suffered acute myelitis. Our patient represents a rare case of late onset Relapsing-Remitting Multiple Sclerosis (RRMS) presenting with an eight-and-a-half-syndrome. Apart from the clinical rarity of eight-and-a-half-syndrome, this case serves as a reminder that MS can occur in every period of life and should be considered in differential diagnosis irrespective of age at onset of neurological symptoms [1].