One of the most common symptoms of multiple sclerosis is visual loss. But the most previous reported cases are unilaterai visual loss due to optic neuritis or retrobulbar optic neuritis or visual field defect due to chiasmal or optic tract lesion. We report a 34 year old female patient who had developed sudden onset of blindenss because of optic chiasm and optic tract lesion. She also complained of involuntary right hand movement and mild left hemiparesis. On T2-weighted image of MRI we found abnormal high sigmal intensities on the optic chiasm, bilateral optic tract, internal capsule and periventricular white matter. Her total blindness has not recovered until the last follow nine months after the initial event.
Adult ; Blindness ; Female ; Hand ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Multiple Sclerosis* ; Optic Chiasm* ; Optic Neuritis ; Paresis ; Visual Fields ; Visual Pathways*

The painful ophthalmoplegia may be caused by various diseases such as tuberculous meningitis, brain tumor, diabetes mellitus, aneurysm of internal carotid artery, nasopharyngeal tumor, temporal arteritis, Tolosa-Hunt syndrome, exophthalmic ophthalmoplegia, ophthalmoplegic migraine and pseudotumor of orbit. Ophthalmoplegic migraine can be diagnosed by the symptom of typical migraine followed by ophthalmoplegia but sbould be a diagnosls of exclusion. The present report describes a case of ophthalmoplegic migraine, a 9 year-old girl with migrainous headache followed by right orbital pain and oculomotor nerve palsy The patient responded well to propranolol. Literatures are briefly reviewed.
Aneurysm ; Brain Neoplasms ; Carotid Artery, Internal ; Child ; Diabetes Mellitus ; Female ; Giant Cell Arteritis ; Headache ; Humans ; Migraine Disorders ; Oculomotor Nerve Diseases ; Ophthalmoplegia ; Ophthalmoplegic Migraine* ; Orbit ; Propranolol ; Tolosa-Hunt Syndrome ; Tuberculosis, Meningeal