Abstract
IntroductionIsolated cranial nerve palsies are considered to be an uncommon presenting feature of multiple sclerosis. Involvement of the trigeminal nerve, particularly its motor component as part of a clinically isolated syndrome of multiple sclerosis has rarely been reported in equatorial regions and no cases have been described in Sri Lanka thus far.Case PresentationWe report a case of isolated right sided trigeminal nerve palsy (Motor and Sensory) in a 34 year old previously well lady from urban Sri Lanka who was found to have characteristic lesions on Magnetic Resonance Imaging highly suggestive of multiple sclerosis.ConclusionsMultiple sclerosis should be considered in the differential diagnosis of patients who present with isolated cranial nerve palsies. Clinicians should have a high index of suspicion when evaluating such patients especially in low prevalence regions close to the equator. Early recognition and treatment of such a “Clinically Isolated Syndrome” may prevent early relapse.
Highlights
Isolated cranial nerve palsies are considered to be an uncommon presenting feature of multiple sclerosis
Despite being a relatively common disease in western countries, multiple sclerosis remains a rare entity in equatorial regions including Sri Lanka [1]
The pathogenesis of cranial nerve involvement in multiple sclerosis is not well described but it is commonly associated with brain stem demyelination [5]
Summary
Multiple sclerosis should be considered in the differential diagnosis of patients who present with isolated cranial nerve palsies. Clinicians should have a high index of suspicion when evaluating such patients especially in low prevalence regions close to the equator. Recognition and treatment of such a “Clinically Isolated Syndrome” may prevent early relapse. Consent Written informed consent was obtained from the patient for publication of this case report and relevant images. A copy of the written consent is available for review by the Editor-in-Chief of International Archives of Medicine. Competing interests The authors declare that they have no competing interests
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