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At least 289 records · Page 16Linked to original sources
PubMed2006

Selective magnetization transfer ratio decrease in the visual cortex following optic neuritis.

Patients with clinically isolated syndromes suggestive of multiple sclerosis have evidence for abnormality in normal appearing grey matter detected using the magnetization transfer ratio (MTR), a quantitative MRI measure. One potential mechanism for the decreased grey matter MTR (GM MTR) observed is trans-synaptic morphological abnormality secondary to demyelinating lesions that are in an anatomically linked pathway but remote location. We investigated this potential association by studying the location of abnormalities using voxel-based analysis of GM MTR maps in a group of 80 patients studied within 6 months of presenting with isolated optic neuritis and compared the findings with those seen in 50 age- and sex-matched healthy controls. Occipital cortex and whole brain analysis comparing all optic neuritis patients and controls revealed a selective decrease of MTR bilaterally in the visual cortex in patients [Brodmann area (BA) 17]. Whole brain analysis of patients fulfilling the McDonald criteria for multiple sclerosis (n = 20) showed a lower MTR compared to controls bilaterally in the visual cortex (BA 17/18), left hippocampus, bilateral superior temporal gyrus, bilateral lenticular nuclei and the right cerebellum. There was no significant difference in the percentage of grey matter between patients and controls in the regions of abnormal MTR detected in the visual cortex. The intrinsic MTR decrease seen in patients suggests that there are structural changes in the visual cortex following an attack of optic neuritis. Potential mechanisms for this include trans-synaptic neuronal degeneration and cortical synaptic morphological changes; such abnormalities may also contribute to MTR abnormalities observed in the normal appearing grey matter in multiple sclerosis.

Adult↗
PubMed2005

P0(106-125) is a neuritogenic epitope of the peripheral myelin protein P0 and induces autoimmune neuritis in C57BL/6 mice.

The present study describes a new model of autoimmune neuritis in C57BL/6 mice induced by immunization with the novel neuritogenic epitope P0(106-125), derived from mouse peripheral myelin protein P0. Immunization with this peptide in combination with pertussis toxin induced high levels of peptide-specific CD4+ T cells in spleen and popliteal lymph nodes. Clinical symptoms of autoimmune neuritis started with a flaccid tail at day 10 postimmunization (p.i.), progressed to moderate paraparesis at day 15 p.i., declining thereafter with undetectable symptoms at day 40 p.i. Clinical disease activity paralleled decreased sciatic nerve motor conduction and histopathologic alterations of sciatic nerves. These included inflammatory infiltrates, mainly consisting of inducible nitric oxide synthase (iNOS)+ macrophages and CD4+ T cells. These data fit into the pathogenetic concept of murine autoimmune neuritis as a CD4+ TH1 cell-mediated disease. Our new mouse model provides an attractive tool to identify critical factors that regulate the severity of autoimmune responses in the peripheral nervous system.

Amino Acid Sequence↗
PubMed2002

Aseptic meningitis and optic neuritis preceding varicella-zoster progressive outer retinal necrosis in a patient with AIDS.

Varicella-Zoster Virus (VZV) is the second most common ocular pathogen in patients with HIV infection. VZV retinitis is estimated to occur in 0.6% of patients with HIV infection and may occur in one of two clinical syndromes. The first is the acute retinal necrosis syndrome, which also may be seen in immunocompetent hosts. The second clinical syndrome occurs in patients with CD4 cell counts typically < 50 x 10(6)/l and is termed progressive outer retinal necrosis. VZV retinitis has been reported to occur simultaneously with other VZV central nervous system manifestations such as encephalitis and myelitis in HIV-infected patients. In addition, VZV retrobulbar optic neuritis heralding VZV retinitis has recently been described in HIV-infected patients who had suffered a recent episode of dermatomal herpes zoster. Herein we report the case of an HIV-infected individual who presented with VZV meningitis and retrobulbar optic neuritis that preceded the onset of progressive outer retinal necrosis. We also review of the literature of seven additional reported cases of retrobulbar optic neuritis preceding the onset of VZV retinitis.

AIDS-Related Opportunistic Infections↗
PubMed1975

Low back pain with femoral neuritis.

In 465 patients treated surgically for low back and lower extremity disability, almost 10 per cent had femoral rather than sciatic distribution of pain. The average age of patients who had a primarily femoral distribution of pain is higher by a decade than those who had a predominantly sciatic distribution of pain; the higher level of the lesion and greater incidence of apophyseal joint arthritis may be associated with the aging process. The femoral distribution of pain may lead to difficulties in differential diagnosis between a spinal origin and a hip or knee origin of the problem. Radiculopathy causing femoral pain may be the result of both disk degeneration with protrusion and apophyseal arthritis with synovitis. Neuritis of the L4 nerve root is more commonly the result of a lesion at the L4-5 nerve root foramen than centrally at the L3-4 disk level. The syndrome of low back pain with femoral neuritis is not uncommon 5 or more years after an otherwise successful L4-S1, two level spine fusion. This syndrome can result from an L3-4 disk protrusion with nerve root neuritis but may be a reflex disturbance from the posterior arch structures as evidenced by fusion mass, apophyseal joint or spinous process overgrowth and associated soft tissue inflammation.

Adult↗
PubMed2002

Heterotopic ossification of peripheral nerve ("neuritis ossificans"): report of two cases.

OBJECTIVE AND IMPORTANCE: Heterotopic ossification ("neuritis ossificans") is among the least frequently encountered reactive lesions in peripheral nerves. Only two cases have been described previously, one in the median nerve of a 34-year-old man, and the other in the ulnar nerve of an adult woman. The architecture of this lesion is distinctly zonal. Consisting of a central fibroblastic core, an intervening zone of osteoid production, and a peripheral layer of ossification, the pattern is remarkably similar to that of myositis ossificans. This similarity and the occurrence of the process in superficial nerves have led to speculation that trauma plays a role in its pathogenesis; this hypothesis remains unproved. We describe two additional cases of neuritis ossificans. CLINICAL PRESENTATION: One patient, a 41-year-old man, experienced pain and numbness in the left leg for several months but had no history of local trauma. A mass was detected in the saphenous nerve. The second patient, a 16-year-old boy, noted subacute onset of pain in the popliteal fossa and decreased sensation in the distribution of the lateral sural cutaneous nerve. A mass was found within the tibial nerve at the knee level. INTERVENTION: In each patient, resection of the mass required sacrifice of a segment of the nerve. CONCLUSION: In each patient, the mass was composed of fibrovascular tissue with osteoid and bone deposition arranged in a zonal pattern. The ossifying process was intraneural but encased rather than directly involving nerve fascicles. These exceptionally intact examples of neuritis ossificans underscore its resemblance to myositis ossificans. Nerve-sparing resection of such masses is not always possible.

Adolescent↗
PubMed1997

Cytomegalovirus optic neuritis.

Cytomegalovirus (CMV) optic neuritis is a rapidly blinding disease. Untreated eyes have a final visual acuity of no light perception. Treated eyes maintain visual acuity of approximately 20/100. Relapse occurs often in subjects maintained on single-dose ganciclovir and is controlled by double-dose ganciclovir. Central visual field testing is indicated to detect indolent cases of optic neuritis, because relapse can be silent with stable visual acuity and fundus appearance. Survival of patients with CMV optic neuritis is comparable to that of a matched group having CMV retinitis alone. Early recognition and therapy of CMV papillitis protect against irreversible visual loss. CMV papillitis does not carry a worse prognosis for survival than CMV retinitis alone.

Antiviral Agents↗
PubMed1998

Optic neuritis.

Advances in magnetic resonance (MR) orbital imaging using fat suppression techniques and contrast enhancement have increased our ability to visualize the area of inflammation in patients with optic neuritis. Our understanding of the natural history of optic neuritis continues to expand. The high risk of developing multiple sclerosis (MS) after an episode of optic neuritis has been confirmed with longitudinal studies. The most important predictive factor for the future development of MS continues to be an abnormal MR image at presentation. Treatment with intravenous steroids temporarily reduces this risk but has no effect on visual outcome. Although subjective visual complaints are common, objective measures of vision show only mild loss in most patients.

Diagnosis, Differential↗
PubMed2005

Recurrent optic neuritis as the presenting manifestation of primary hypereosinophilic syndrome: a report of two cases.

Two patients sustained multiple attacks of optic neuritis with persistent visual loss. An elevated eosinophil count was initially considered an incidental finding. Years later, the diagnosis of primary hypereosinophilic syndrome (HES) was confirmed by skin and bone marrow in one patient and by lung biopsy in the other. Treatment with hydroxyurea in one patient and with continuous low-dose prednisone in the other stopped the optic neuritis attacks, resolved systemic manifestations, and stabilized neurologic manifestations. These cases emphasize that primary HES may be a cause of recurrent optic neuritis, and that delay in diagnosis and treatment of primary HES can lead to visual morbidity.

Biopsy↗
PubMed2003

Combination of high-dose intravenous immunoglobulins and itraconozole in treating chronic mycotic demyelinating optic neuritis.

Mycotic demyelinating optic neuritis is a neurological disorder of the visual system caused by mycotoxins released by indoor toxic molds. Although the health effect of indoor toxic mold on the population worldwide is now one of the "emerging diseases", its involvement in chronic demyelinating optic neuritis has not been reported. Most of the neurological and immunologic abnormalities associated with toxic mold mycotoxins are very difficult to treat successfully, especially neural demyelination of the central and peripheral nervous systems. This paper presents the case of a 42-year-old white female, in whom chronic demyelinating optic neuritis with persistent visual defects due to chronic exposure to toxic molds was diagnosed at the age of 34 years. In spite of all the therapeutic services given to her for over 8 years, her illness persisted and was difficult to treat. However, we successfully treated her with a combination of intravenous immune globulin (IVIG) and itraconozole (Sporanox) when all other treatment modalities failed. This is probably the first report where persistent toxic mold-induced neurological and immunologic disorders were successfully treated with a combination of itraconozole and IVIG.

Adult↗
PubMed1998

Optic neuritis following albendazole therapy for orbital cysticercosis.

PURPOSE: To report the occurrence of optic neuritis following oral albendazole therapy for orbital cysticercosis. METHODS: Two patients having definitively diagnosed orbital cysticercosis at the orbital apex developed an acute visual loss 1 week after initiation of oral albendazole. Ultrasonography and magnetic resonance imaging determined that the cause was optic neuritis due to disorganization of the cyst with inflammation of the adjacent optic nerve. RESULTS: Oral corticosteroids (prednisolone 1 mg/kg per day) given for a period of 4 weeks led to resolution of the optic neuritis, with full visual recovery. CONCLUSION: Corticosteroids should be given in addition to albendazole in the treatment of orbital cysticercosis when cysts are in close proximity to the optic nerve.

Administration, Oral↗
PubMedDate not supplied

Tick-borne encephalitis virus as a possible cause of optic neuritis in a dog.

A 3-year-old spayed female Siberian Husky was presented due to acute vision loss. Examination revealed bilateral optic neuritis and lymphocytic meningoencephalitis. The serum (1:800) and cerebrospinal fluid (CSF; 1:200) immunoglobulin (Ig)G titers for tick-borne encephalitis virus (TBEV) were elevated as were the serum IgG titer for Anaplasma phagocytophilum (1:640) and serum IgM titer for Toxoplasma gondii (1:20). Intracytoplasmic inclusion bodies such as ehrlichial or anaplasmal morulae were not observed in the CSF or blood smear. The dog was treated with methylprednisone and doxycycline. The left eye regained vision; the right eye remained blind. Anti-inflammatory therapy was stopped on day 18 after diagnosis. Four days later the dog showed evidence of hyperesthesia in the cervical region. Analysis of CSF showed no abnormalities and CSF IgG titers for TBEV and A. phagocytophilum were negative. Funduscopic evidence of active papillitis was absent on day 22 in the left eye and on day 86 in the right eye. On day 243, the dog was presented again with lethargy, ataxia, disorientation and temporary head tilt. The IgG titer for TBEV was again elevated in the CSF (1:800) and in serum (1:400). After interpretation of all findings, we assume that meningoencephalitis and optic neuritis in this patient was caused by TBEV and associated immune-mediated inflammation. In endemic areas, TBEV should be considered as cause of optic neuritis in dogs.

Animals↗
PubMed1988

Optic neuritis in children and its relationship to multiple sclerosis: a clinical study of 21 children.

The optic neuritis of 21 children aged between four and 14 years generally was characterized by bilateral involvement (62 per cent) and papillitis (76 per cent). Often acute infections or vaccinations were preceding events. Frequently there was pleocytosis during the disease process, with production of IgG, oligoclonal and viral antibodies, which increased during follow-up. Nine of these children (eight female) later developed multiple sclerosis, with unilateral involvement of the optic nerves and HLA Dr2 positivity. Disseminated effects on the central nervous system were similar to those of adults with multiple sclerosis. In all cases these relapses occurred within one year of the optic neuritis. EEGs did not differentiate those who developed multiple sclerosis from those who did not, but four of five patients with multiple sclerosis who were followed-up for a year or more had paroxysmal discharges, and one of the four had manifest epilepsy. Magnetic resonance imaging, visual and sensory evoked potentials and CSF studies were helpful in diagnosing multiple sclerosis. The visual prognosis was good in most cases. 17 children had no or only slight neurological disability at the end of follow-up; the other four had moderate to severe disability. This study suggests that optic neuritis is a diffuse disease, not merely affecting the optic nerves, and that the immunological events typical of multiple sclerosis can start in childhood.

Adolescent↗
PubMed1978

Pulfrich pendulum phenomenon in patients with a history of acute optic neuritis.

The Pulfrich phenomenon is a stereoillusion in which a pendulum swinging at right angles to the line of gaze appears to be describing an elliptical path when absorbing filters are placed in front of one eye. We used two sets of polaroid glasses as adjustable filters. A spot on a modified oscilloscope served at a pendulum bob. Twenty-nine former patients with a history of optic neuritis and visual acuities of greater than or equal to 6/6 in both eyes and twenty-two normal subjects underwent examinations. The patients showed pathological recordings which separated them from the control subjects. The test seems to expose minor residual dysfunction of affected optic nerves where the visual acuity is normalized. This abnormal response when viewing the moving Pulfrich pendulum is probably caused by disturbed neural conduction. The degree of acute visual loss and the time elapsed since the attack did not seem to influence the Pulfrich response. The results may explain why some patients who have recovered from optic neuritis complain of difficulties when viewing moving objects. In addition to the use of Pulfrich illusion test for diagnostic work; i.e. clinical or subclinical attacks of optic neuritis, it can serve as a valuable supplement to the more sophisticated method of visual evoked response.

Acute Disease↗
PubMed1983

Experimental allergic neuritis-like disease in rabbits after injection with influenza vaccines mixed with gangliosides and adjuvants.

An experimental allergic neuritis-like disease was induced in rabbits 3 to 8 weeks after injection with large doses of influenza vaccines mixed with gangliosides, cholesterol, and Freund complete adjuvant. The inclusion of gangliosides was essential to induce the experimental allergic neuritis-like disease. In trials with six different lots of vaccine, both swine influenza and non-swine influenza vaccines produced by four different manufacturers induced experimental allergic neuritis-like disease in 26 of 43 inoculated rabbits.

Animals↗
PubMed2006

Clinical profile of simultaneous bilateral optic neuritis in adults.

AIM: To establish the clinical profile of simultaneous bilateral optic neuritis in adults, the efficacy of steroid therapy, extent of visual recovery, and neurological outcome. METHODS: The authors performed a retrospective review of records of patients referred to a neuro-ophthalmology service with acute bilateral optic neuritis from 2000-4. Exclusion criteria included previous multiple sclerosis or myelopathy, known systemic disorders or medications associated with optic neuropathy, uveitis, or neoplasm. Patients received intravenous methylprednisolone followed by oral prednisone. Visual acuity (logMAR conversion), mean deviation (dB) for visual fields, percentage of Ishihara plates seen, ophthalmoscopy, and neurological evaluation were recorded at baseline and at 6 months or 12 months. Owing to strong correlation for visual loss between eyes, the results for the worse eye in each patient were analysed. RESULTS: 11 men and four women, with an age range of 18-64 years, had bilateral decreased vision, 12 with pain on eye movement. Except for one patient, no aetiology was found. All patients had normal neurological evaluations, average visual acuity 1.71 (SD 0.55), colour vision 2.7% (SD 9.9%), and mean deviation -25.35 dB (SD -7.95 dB). Both optic nerves showed abnormal signal on magnetic resonance imaging. 14 patients improved and their last average visual acuity, colour vision, and mean deviation were 0.36 (SD 0.54), 69% (SD 46%), and -7.05 dB (SD 8.40 dB), respectively. No patient developed a neurological problem during the follow up with a mean of 11 months. CONCLUSION: Idiopathic acute bilateral optic neuritis without myelopathy occasionally occurs in adults. Vision recovers with corticosteroid therapy and during the first year neurological dysfunction will frequently not occur.

Acute Disease↗
PubMed2006

Quantification of optic nerve head topography in optic neuritis: a pilot study.

AIMS: To investigate optic nerve head topography in patients with optic neuritis compared to controls using the Heidelberg retina tomograph-II (HRT-II) and to determine if detected changes are related to visual function and electrophysiology. METHODS: 25 patients with a previous single episode of unilateral optic neuritis and 15 controls were studied with HRT-II, visual evoked potentials, and pattern electroretinogram. Patients also had testing of visual acuity, visual field, and colour vision. RESULTS: In affected eyes compared to fellow eyes, there was reduction of both the mean retinal nerve fibre layer (RNFL) thickness at the disc edge (p = 0.009) and the neuroretinal rim volume (p = 0.04). In affected eyes compared to control eyes, the three dimensional optic cup shape measure was increased (p = 0.01), indicative of an abnormal cup shape. There were no other significant differences in HRT-II measures. Within patient interocular difference correlation was used to investigate the functional relevance of these changes and demonstrated associations between RNFL thickness change and changes in visual acuity, visual field, and colour vision. Colour vision change was also associated with change in neuroretinal rim volume. CONCLUSIONS: HRT detects functionally relevant changes in RNFL thickness and neuroretinal rim volume between eyes affected by optic neuritis and unaffected fellow eyes.

Adult↗
PubMed2006

Is the frequency of abnormalities on magnetic resonance imaging in isolated optic neuritis related to the prevalence of multiple sclerosis? A global comparison.

The link between optic neuritis and multiple sclerosis is well established, as is the increased risk of conversion to multiple sclerosis, with lesions seen at presentation on the magnetic resonance imaging (MRI) scan of the brain. One or more asymptomatic lesions were present in 77% of the optic neuritis cohort from London, UK, a higher proportion than that reported in other large cohorts studied elsewhere, where generally lower prevalence rates for multiple sclerosis are also reported. These observations may support the hypothesis that optic neuritis is more likely to be associated with abnormalities on MRI and to be due to multiple sclerosis in geographical regions where multiple sclerosis is more common.

Adolescent↗
PubMed1976

Acute optic neuritis and the prognosis for multiple sclerosis.

In a retrospective survey of acute optic neuritis 144 cases in adults were found and, of these, 127 were reviewed, five had died of causes related to multiple sclerosis, and 12 were lost to follow-up. There was a statistically significant seasonal variation in the incidence of optic neuritis. When the life-table method of analysis was used, the probability of developing multiple sclerosis rises to 78% 15 years after an episode of optic neuritis. At review, 49 (73%) of the 67 patients with multiple sclerosis were independent and leading active lives.

Acute Disease↗