Introduction: We report a case of bilateral third cranial nerve palsy in a patient with a secondary progressive multiple sclerosis.
Observation: MRI revealed a large hyperintense lesion in T2-weighted images in the mesencephalic area. The clinical and radiological outcome was good after intravenous methylprednisolone. The oculomotor signs were probably caused by this mesencephalic lesion.
Conclusion: This case of bilateral third cranial nerve palsy is, to our knowledge, the first one occurring in a patient with multiple sclerosis.
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