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

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. Neurology Asia 2015; 20(3) : 305 – 307 Address correspondence to: Ali UlviUca, Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, Nöroloji Anabilim Dalı. Meram, 42080, Konya, Turkey. Tel: +90 332 223 7981, E-mail: [email protected] INTRODUCTION Cluster-tic syndrome is a rare headache syndrome characterized by the coexistence of three types of pain attacksin which trigeminal neuralgia co-occurs with cluster headache. We report the case of a patient diagnosed as having cluster-tic syndrome and bilateral internuclear ophthalmoplegia (INO) as the manifestation of multiple sclerosis (MS). We are not aware of previous similar report in the literature.