Tolga CETINDAMAR, Ozge Arıcı DUZ, Aysenur CILA
Journal of Multiple Sclerosis Research - 2026;6(1):50-53
Peripheral nerve and nerve root involvement are rare manifestations of multiple sclerosis (MS) and may pose diagnostic challenges by mimicking other inflammatory or systemic disorders. We report the case of a 26-year-old man who presented with acute right-sided facial numbness, mild hearing impairment, and imbalance. Brain magnetic resonance imaging (MRI) demonstrated demyelinating plaques in the pons and the periventricular and subcortical white matter, accompanied by contrast enhancement of the cisternal and intrapontine segments of the right trigeminal nerve. Spinal MRI revealed focal cervical and thoracic cord lesions with symmetric enhancement of the proximal cauda equina nerve roots. Cerebrospinal fluid analysis showed a normal cell count, an immunoglobulin G index of 0.68, and a type 3 oligoclonal band pattern. The patient demonstrated marked clinical and radiologic improvement following treatment with high-dose intravenous methylprednisolone and was subsequently started on disease-modifying therapy. This case highlights a rare radiologic manifestation of MS and underscores the importance of considering MS in the differential diagnosis of concurrent cranial nerve and cauda equina root enhancement.
