Diplopia in MS

Q: Diplopia in Multiple Sclerosis (MS) is usually? (select one)

A) painful

B) painless

Answer: B

If a patient with MS encounters diplopia, it is usually painless. This occurs due to internuclear ophthalmoplegia or sixth nerve palsy. In contrast, optic neuritis is usually unilateral, painful, and with monocular visual loss manifested by visual blurring or scotoma.

Partial transverse myelitis may occur, usually with predominant sensory symptoms, including a partial Brown-Sequard syndrome. Sphincter symptoms usually occur is such situations.

Interestingly many of these symptoms resolved without treatment though now with more awareness, most patient receives treatment for MS exacerbation or relapse.

#neurology

References:

1. Costello F. Vision Disturbances in Multiple Sclerosis. Semin Neurol. 2016 Apr;36(2):185-95. doi: 10.1055/s-0036-1579692. Epub 2016 Apr 26. PMID: 27116725.

2. Graves J, Balcer LJ. Eye disorders in patients with multiple sclerosis: natural history and management. Clin Ophthalmol. 2010 Dec 6;4:1409-22. doi: 10.2147/OPTH.S6383. PMID: 21188152; PMCID: PMC3000766.