Double vision followed by...

A 35-year-old woman sought treatment for double vision at the neurology department of a general hospital. MRI discovered a T2 high-intensity lesion in the midbrain with gadolinium enhancement (Fig. C). After receiving oral steroid therapy, she saw an instant improvement in her symptoms. However, she did not take relapse treatment. After two years, she had painful hyperesthesia in a region comparable to the right C5 segment regarding neurological symptoms. The MRI showed a T2 high-intensity lesion in the left posterior funiculus extending from segment C4 to C5 (Fig. D). Her symptoms improved after receiving intravenous methylprednisolone medication.