Neuroimmunology

Abstract

A 39-year-old woman came to the ER complaining of progressive left-sided weakness for 3 days. A few days prior, she had gradually developed right-sided sensory loss that lasted 48 hours with complete resolution. On further questioning, she stated that she experienced partial left visual loss 10 weeks ago that seemed to have recovered completely over 2 months and noticed double vision on looking to the left. Neurological examination revealed a left afferent pupillary defect, right adduction paresis with left abduction nystagmus, mild left lower facial droop, MRC 4/5 strength in the left upper and lower extremities, mild right hemisensory loss to pinprick and light touch, and left-sided hypertonia and hyperreflexia with an extensor plantar response.