Teaching brainstem anatomy using a sharply-located demyelinating plaque of multiple sclerosis

Ensinando anatomia do tronco cerebral através da exata localização de uma placa desmielinizante de esclerose múltipla

Studying neuroanatomy can be made more interesting when clinical and imaging findings show correlations within areas of the central nervous system. This young woman presented with diplopia and had a demyelinating plaque in the region of the left abducens nucleus. Remaining lesions and spinal fluid analysis confirmed her diagnosis of multiple sclerosis¹. In neuroanatomy classes, vascular lesions and tumors are often used to show the exact location of brain structures, but multiple sclerosis is not usually presented to students with this purpose. Students may improve their understanding of neuroanatomy when the relevance of the subject is made clear by medical cases (Figure).

Figure
Demyelinating lesion at the posterior limit of the pons and mesencephalon marked the exact spot (left abducens nucleus) of a plaque generating the clinical findings of diplopia due to left abducens nerve paresis (shown in the patient's photograph).

Reference

• ¹
  Krieger SC, Cook K, De Nino S, Fletcher M. The topographical model of multiple sclerosis: A dynamic visualization of disease course. Neurol Neuroimmunol Neuroinflamm. 2016 Sep;3(5):e279. https://doi.org/10.1212/NXI.0000000000000279
  » https://doi.org/10.1212/NXI.0000000000000279

Publication Dates

• Publication in this collection
  23 Sept 2019
• Date of issue
  Sept 2019

History

• Received
  10 Dec 2018
• Reviewed
  04 Mar 2019
• Accepted
  26 Mar 2019