Patients with MS may present with extraocular muscle dysfunction. Demyelinating lesions in the brainstem and/or cerebellum can cause gaze palsies or ocular misalignment with horizontal, vertical, and/or oblique diplopia.
Of note, efferent visual pathway lesions may be more challenging to identify than those in the afferent visual pathway, as affected patients do not experience pain and therefore may not report symptoms. MS should be considered in young patients presenting with painless diplopia.
Learn more about efferent visual manifestations of MS.
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Cite this: Christopher Luzzio. Fast Five Quiz: Multiple Sclerosis Signs and Symptoms - Medscape - Jan 05, 2021.