A 35-year-old man was admitted for evaluation of right and left hemibody numbness, incoordination, diplopia, and right-sided facial weakness.

This 35-year-old man was admitted with bilateral numbness, incoordination, diplopia, and right facial weakness. On examination he had paralysis of conjugate gaze to the right, right upper and lower facial muscle weakness, left hemiparesis leading to gross dysmetria on finger-to-nose and heel-to-shin testing, and an ataxic wide-based gait (ataxic hemiparesis). Magnetic resonance imaging (MRI) demonstrated a focus of high signal intensity in the pons at the level of the middle cerebellar peduncle (brachium pontis) and smaller areas of high signal intensity involving the subcortical white matter of both hemispheres. He was diagnosed with MS.