3 months of mild fluctuating confusion, altered behavior and ataxia. New right-sided hearing loss (SNHL).
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Multiple FLAIR hyperintense and diffusion restricted lesions in the corpus callosum, the largest in the splenium on the left. Numerous bilateral white matter lesions in a semiovale distribution of similar signal intensity. No brainstem lesions.
Given the history and MRI features (particularly the callosal lesions), a provisional diagnosis of Susac syndrome was made with the differential of multiple sclerosis. The patient was treated with steroids and the symptoms and lesions resolved although there was some permanent mild hearing loss.