HOMONYMOUS HEMIANOPIA AS THE INITIAL MANIFESTATION OF MULTIPLE-SCLEROSIS

A 28-year-old male patient in good health with no previous neurologic or ophthalmoscopic abnormalities developed right homonymous hemianopsi a. Magnetic resonance (MR) imaging demonstrated bilateral high-signal suprageniculate lesions, The lesion located in the left parieto-occipi tal area was compatible with the field defect observed. Oligoclonal ba nds were present in the cerebrospinal fluid, Testing of visual-evoked potentials revealed increased latencies in both eyes. The patient was given 1 g/day intravenous methylprednisolone for 3 days. The visual fi elds, as determined by automated static perimetry, recovered completel y in 2 weeks, Follow-up MR imaging at 1 month showed no change compare d to baseline, Seven months after the initial attack he suffered right internuclear ophthalmoplegia, which resolved spontaneously within 1 w eek, Based on the clinical and radiologic findings, the final diagnosi s was made as clinically definite multiple sclerosis (MS). This patien t represents a rare case of MS presenting first with homonymous hemian opsia.