Multiple Sclerosis Manifested by Paralysis of Cranial VI Pair with Diplopia

Aims: To describe a Multiple Sclerosis Manifested by Paralysis of Cranial VI Pair with Diplopia.

Presentation of Case: A.P.R. female patient, 31 years old, has presented diplopia for 04 days. She denied too many symptoms and comorbidities. No eye trauma and previous eye surgery.

Discussion: Multiple Sclerosis (MS) is a chronic, immune-mediated and demyelinating disease of the central nervous system that mainly affects young female adults. About 85% of individuals with MS start the clinical picture in the form of a relapse, and less can open the picture with progressive neurological deficits, although occasional relapses occur during the course of the disease. Eye changes are frequent in MS and are often the first clinical manifestation.

Results: MS is a rare comorbidity and there are no exact and concrete epidemiological studies so far. Studies about eye alterations are also scarce in Latin American countries.

Ocular involvement may be the first sign of MS. Although MS is an uncommon cause of cranial nerve palsies, its frequency increases in young individuals, with a predominance of abducens nerve palsy, as occurred with the patient in the present report, emphasizing the importance of knowing the profile of this disease.

Conclusion: Ocular findings in MS include optic neuritis, retinitis, peripheral vasculitis, ocular motility abnormalities that can manifest as diplopia or nystagmus, and these manifestations should be recognized by ophthalmologists.