Marcus Gunn Pupil with bilateral lower leg motor loss?

[Chandler]

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Anyone know what disease is likely for a patient 65 year old male with a Marcus Gunn Pupil and a bilateral loss of motor activity in the legs? This is driving me nuts. If the presentation was an Argulyll Robertson pupil or if the patient was in his 20's I wouldn't be overanalyzing this to death.

 

[neglect]

Anyone know what disease is likely for a patient 65 year old male with a Marcus Gunn Pupil and a bilateral loss of motor activity in the legs? This is driving me nuts. If the presentation was an Argulyll Robertson pupil or if the patient was in his 20's I wouldn't be overanalyzing this to death.

Devics comes to mind.

 

[Chandler]

Devics comes to mind.

OMG!!! You are right! Thanks for the help. I read the article below. This was on my exam!! The question described Marcus Gunn Pupils, and described how the person had trouble with motor loss in the lower trunk. What's the chance this is in any preparation books!

I can't believe they would ask a question about this disease to students that just completed 2 years of medical school! What's even more amazing is that all of the answer choices on the exam described what you would find at the molecular level for this disease.

http://www.myelitis.org/devics_disease.htm

 

[NR117]

I'll tell you what's even MORE amazing - Devic's disease, or neuromyelitis optica, typically involves both eyes. Unless one eye is affected more than the other, you would NOT see a relative afferent pupillary defect (Marcus Gunn pupil).
So there you go...This is what you get when people preparing the questions don't know what they are doing: A very poorly written exam question.. 😡