Cluster-tic syndrome and bilateral internuclear ophthalmoplegia as the manifestation of multiple sclerosis

ABSTRACT

This report describes a 35-year-old female suffering from a cluster-tic syndrome and bilateral internuclear ophthalmoplegia as the initial manifestation of multiple sclerosis. Magnetic resonance imaging of the brain revealed multiple pontine hyperintense lesions. To our knowledge, there is no previous report of multiple sclerosis presenting as cluster-tic syndrome and bilateral internuclear ophthalmoplegia in the literature. The cluster headache attacks and peri-ocular neuralgiform pain resolved after treatment with intravenous methyl-prednisolone and oral carbamazepine.