Importance of Neurootologic Examination in Diagnosing Multiple Sclerosis with Abnormal Eye Movement

We report a 62-year-old man with left paramedian pontine reticular formation (PPRF) disorder. Seven years later, primarily found symptoms such as diplopia with left facial palsy and perceptual disorder changed to left one-and-half (OAH) syndrome. We compared results of neurootologic examination to those of magnetic resonance imaging (MRI), which has purportedly played a central role in diagnosis and management of multiple sclerosis (MS). MS is a prototypic inflammatory demyelinating disorder of the central nervous system. Our subject, however, had no lesions causing abnormal eye movement on MRI. He had abnormal neurootologic findings related to his disease, and neurootologic results appeared more sensitive than those of MRI. While MRI is invaluable in diagnosis, it can not reveal all MS lesions. We hold that, in addition to MRI, neurootologic examination is useful in diagnosing and evaluating abnormal eye movement.