A 27-year-old woman with no prior neurologic history presents with acute onset of diplopia and facial numbness. Vital signs show BP 118/76, HR 88, RR 16, temperature 37.2°C, SpO2 98% on room air. Examination reveals bilateral internuclear ophthalmoplegia and facial sensory loss. Brain MRI demonstrates bilateral brainstem T2-hyperintense lesions. CSF analysis shows normal glucose and protein. She denies fever or recent infections. Which of the following is the most likely diagnosis?
- A)Vertebrobasilar insufficiency
- B)Multiple sclerosisGABARITO
- C)Brainstem glioma
- D)Lyme disease
- E)Miller Fisher syndrome
Explicação
Multiple sclerosis presenting with bilateral brainstem lesions causing bilateral INO and cranial nerve involvement (facial sensory loss via CN V) is typical for demyelinating disease. The acute presentation with multifocal CNS involvement in a young woman is c... Ver explicação completa e trilha adaptativa →