Demyelination with bilateral facial colliculus involvement

Case contributed by Dr Andrew Dixon


New onset bilateral internuclear ophthalmoplegia.

Patient Data

Age: 25
Gender: Male

Bilateral high T2 signal, high DWI signal and enhancement of the facial colliculus. Mutliple supratentorial lesions involve the periventricular white matter and subcortical u-fibers, with the larger lesions demonstrating enhancement. 

Bilateral facial colliculus enhancement due to active demyelination. This patient presented with internuclear ophthalmoplegia as part of facial colliculus syndrome.  

Case Discussion

An example of demyelination presenting with internucelar ophthalmoplegia / facial colliculus syndrome due to bilateral involvement of the facial colliculus. The patient had other active demyelinating lesions involving periventricular white matter and subcortical u-fibers as part of a clinically isolated syndrome.

Given the lesion distribution, the patient would be highly likely to progress to further episodes and a diagnosis of multiple sclerosis.  

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Case information

rID: 38552
Published: 24th Jul 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included