A 30-year-old woman presents with acute-onset diplopia and gait imbalance. Vital signs: BP 118/76, HR 88, RR 16, Temp 37.2°C, SpO2 98%. On neurologic exam, leftward gaze produces failure of right eye adduction with left eye abducting nystagmus; convergence remains intact. Brain MRI reveals periventricular T2 hyperintensities. She denies prior neurologic symptoms. Which of the following best explains these findings?
- A)Optic neuritis
- B)Transverse myelitis
- C)Amyotrophic lateral sclerosis
- D)Multiple sclerosis
- E)Internuclear ophthalmoplegia from medial longitudinal fasciculus lesionGABARITO
Explicação
This eye movement pattern is internuclear ophthalmoplegia caused by a lesion of the medial longitudinal fasciculus. In a young adult woman, demyelination from multiple sclerosis is the classic cause of this finding. Ver explicação completa e trilha adaptativa →