Public forum - Last update 14.12.2015


Brainstem Functions


What would an isolated bilateral internuclear ophthalmoplegia score?

A unilateral complete internuclear ophthtalmoplegia (INO) would result in a brainstem FS 3, actually because of sustained nystagmus. You cannot get a higher FS score if there is only extraocular movement impairment or nystagmus, so a bilateral INO still scores a 3.


One patient had a trigeminal nerve ablation a year ago for trigeminal neuralgia and currently has hypesthesia of the second branch of trigeminal, would have a score of 0?

If trigeminal neuralgia was MS related it is a consequence of the treatment and therefore the score would be 2 in Brainstem.


Does a patient with only a one and one-half syndrome have a Brainstem functional score of 3?

Yes. The patient is scored "marked" in EOM. And if this is the only deficit, the Brainstem functional score is 3.


In the Brainstem FS, a patient has isolated moderate extraocular movement impairment. There are no other deficits in the Brainstem FS. What is the Brainstem FS score?

If a patient has isolated moderate extraocular movement impairment, the Brainstem FS score is 3. In Kurtzke's original paper, moderate and marked were used as equivalent terms in describing the degree of impairment in extraocular movements.