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PubMed1980

Passive transfer of demyelination by experimental allergic neuritis serum.

Serum from rabbits with experimental allergic neuritis (EAN) when injected into rat sciatic nerves produced rapidly evolving demyelination followed by remyelination. Myelinating and non-meylinating Schwann cells as well as myelin itself were damaged by 15 min after injection. Myelin degradation was well advanced prior to involvement by macrophages at 12 h. The demyelinating factor was myelin-specific and complement-dependent. The evidence suggests that the EAN antigen may reside in Schwann cell membranes as well as in myelin.

Animals↗
PubMed1993

Visual evoked potentials after optic neuritis. Effect of time interval, age and disease dissemination.

Visual evoked potentials (VEPs) were compared among six groups of patients tested at various times after an episode of acute unilateral optic neuritis (ON). The incidence of abnormalities ranged from above 90% in patients tested during the first 6 months to about 70% when more than 2 years had elapsed. Compared with the acute stage (1-8 weeks), latency prolongation was almost 50% less in patients tested after 2-19 years. In the latter group, latencies were significantly correlated with the patients' age at the time of the attack. The findings confirm and extend the evidence of serial studies which shows that the shortening of VEP latency is a general phenomenon which proceeds for up to 2 years and possibly for longer in younger patients. When the patients with clinically isolated ON were compared with those who had a history of additional neurological episodes suggestive of multiple sclerosis (MS), up to 4 weeks after ON latencies were more prolonged in the MS group but between 4 and 8 weeks amplitudes were larger and between 8 weeks and 2 years latencies were significantly shorter. No significant differences were found in patients tested after more than 2 years. It is suggested that the electrophysiological deficit may initially be more severe in patients with disseminated disease, but that recovery may occur faster.

Adolescent↗
PubMed1993

Distinct patterns of spatial frequency response by normal, recovered optic neuritis, and normal fellow eyes to a new linearly variable neutral density device.

Upon apparent recovery from optic neuropathy, structural damage to the optic nerve may remain while usual measures of visual function appear normal. To test for such damage, the logarithm of optical density to cause a pattern to disappear is read directly on the scale of our device. Patients in the first study observed the disappearance of a red Amsler grid; this Threshold Amsler Score, used jointly with acuity scores, separates normal eyes from eyes with optic neuropathies. Patients in the second study used the device to measure the disappearance of the highest contrast Vistech patterns to show that this device, used over a range of spatial frequencies, differentiates "subclinical" neuropathies (recovered optic neuritis eye; never symptomatic fellow eye to a diagnosed eye) from normal eyes. This device may measure the functional photopic brightness of the stimulus pattern; when the score from our device is higher, the range of photopic brightness for the stimulus is wider, and the retina is more sensitive to contrast.

Adolescent↗
PubMed1990

Pattern electroretinograms in optic neuritis during the acute stage and after remission.

A total of 20 patients with unilateral acute optic neuritis were studied. Each patient had experienced the recent onset of a decrease in visual acuity, a relative afferent pupillary defect, a relative or absolute central scotoma and a colour-vision defect. The pattern-reversal electroretinogram (PERG) of each patient was analysed with regard to the amplitude of the positive and negative components. During the acute stage the amplitude of the positive component was reduced in all patients and that of the negative, in 18 of 20 cases. Parallel to clinical recovery, a steady increase was observed in the amplitude of the positive component to normal values; no statistical differences between affected and fellow eyes was found. In contrast, the amplitude of the negative component remained significantly reduced after clinical recovery.

Acute Disease↗
PubMed1983

Cholinesterase activities in the autonomic nervous system of rabbits with experimental allergic neuritis: a biochemical study.

Utilizing a colorimetric method with acetylthiocholine iodide (AThCh) as substrate and eserine and ethopropazine as inhibitors, the activities of AThCh-splitting enzymes, acetylcholinesterase (AChE) and non-specific esterase (psi ChE) were determined in different structures of the autonomic nervous system (ANS) from the left and from the right sides of rabbits with experimental allergic neuritis (EAN) and controls. The total activity of AThCh-splitting enzymes showed a highly significant decrease in the ganglion nodosum and in the ganglia of the thoracal and abdominal paravertebral sympathetic chain in rabbits with clinical symptoms of ANS-involvement. Lesser but still significant changes were found in EAN-rabbits with motor symptoms but without ANS symptoms. No definite changes could be found in the superior cervical ganglia, the cervical sympathetic trunk or the interganglionic portions of the abdominal and thoracal paravertebral sympathetic chains. In samples with decreased total enzyme activities, both AChE and psi ChE appeared to decrease to approximately the same extent. This study demonstrates that the activities of AThCh-splitting enzymes are decreased in EAN in parts of ANS innervating the heart, abdominal and pelvic organs, and suggests that enzyme activities not derived from the myelin sheath may be involved in the pathogenesis of this demyelinating disease.

Acetylcholinesterase↗
PubMed1990

Proteolysis of peripheral nerve myelin in acute experimental allergic neuritis.

Proteolysis of peripheral nerve myelin was studied in rats with experimental allergic neuritis (EAN). In vitro measurements using rat sciatic nerve homogenate and denatured bovine myelin as a substrate showed two myelin specific enzyme activities at pH 3.8 (inhibited by pepstatin) and pH 5.8 (inhibited by PMSF) in the normal rat and newly appearing activities at pH 2.8 (inhibited by pepstatin) and pH 5.0 (not characterized) in the EAN rat. In EAN the proteolytic activity was not restricted to myelin substrate but degraded total sciatic nerve protein as well. Endogenous sciatic nerve protease at pH 5.8 did not significantly change in activity during the course of disease. On the contrary, activity of acid protease at pH 2.8 corresponded well to the disease. Myelin degradation in EAN, therefore, appears to be mainly due to exogenous non-tissue protease.

Acute Disease↗
PubMed1975

The node of Ranvier in experimental allergic neuritis: an electron microscope study.

Pathological breakdown of the node of Ranvier in experimental allergic neuritis (EAN) in the rabbit was examined by electron microscopy. The study was concerned principally with the mechanism of disruption of paranodal myelin. Two types of change in myelin structure were observed, both apparently related to the presence of cytoplasmic processes of macrophages: (1) a vesicular disorganization of myelin lamellae and (2) a separation of myelin lamellae. Both methods of disorganization were used by macrophages as they apparently lifted off the myelin terminal loops of the paranode from the underlying axon and also penetrated between myelin loops and adjoining myelin lamellae. In some pathologically damaged nodes of Ranvier no macrophages were observed. The findings raise important immunological and electrophysiological questions concerning the involvement of the macrophage in the autoimmune response and the effect of the loss of paranodal myelin on nerve conduction.

Animals↗
PubMedDate not supplied

Q fever meningoencephalitis associated with bilateral abducens nerve paralysis, bilateral optic neuritis and abnormal cerebrospinal fluid findings.

Q fever is an zoonosis caused by Coxiella burnetti, the clinical features of which are often nonspecific and self-limited. Involvement of the central nervous system is rare and is usually seen as a complication of endocarditis caused by this rickettsial organism in the chronic disease. Specific neurological manifestations in the course of the acute illness aseptic meningitis, encephalitis, toxic confusional states, extrapyramidal signs, dementia and behavioral disturbances. We describe a patient who developed reversible bilateral abducens nerve paralysis and bilateral optic neuritis in the course of acute Q fever meningoencephalitis.

Abducens Nerve↗
PubMed1996

Long time echo STIR sequence magnetic resonance imaging of optic nerves in optic neuritis.

Magnetic resonance images of optic nerves were obtained in 20 patients with acute optic neuritis (ON), and assessed by means of clinical, visual field and visual evoked potential evaluations; the imaging was repeated 1 year later. The results of the conventional Short Tau Inversion Recovery (STIR) sequence obtained using short time echo (STE-STIR: 22 msec) were compared with those of the long time echo sequence (LTE-STIR: 80 msec). The conventional STE-STIR sequence revealed lesions in 57.2% cases of acute ON and in 42.9% of the optic nerves affected by previous ON; the LTE-STIR sequence was diagnostic in 95.2% of acute ON cases and in 85% of patients with previous ON. The calculated length of the optic nerve lesions was significantly longer in the images obtained using the LTE-STIR sequence than in those obtained using conventional STE-STIR sequences.

Adult↗
PubMed1996

Are VEP abnormalities in optic neuritis (ON) dependent on plaque size? A reappraisal of the physiopathology of ON based on improved MRI and multiple-lead recordings.

Twenty patients with optic neuritis (ON) described in the previous study [23] underwent serial VEP recordings (using multiple electrode arrays) for two years. The VEPs could be correlated with the lesions revealed by MRI, Visual Field tests and other clinical findings. On the basis of their scalp distribution, they were classified as "really delayed" VEPs and "pseudo-delayed" VEPs. Real delays could be recorded at the onset of ON or shortly afterwards, and their appearance indicated the recovery of visual function and a good prognosis. Pseudo-delays indicated an alteration in the visual field and, unless a breakthrough of normal or delayed components appeared in the first three months, following acute ON, indicate a poor prognosis for the recovery of visual function. The pseudo-delayed VEPs were mainly observed in patients with longer lesions revealed by means of LTE-STIR MRI [23]; there was no correlation between VEP latency and the length of plaques. Our findings contradict previous theories on the timing of conduction alterations in ON and multiple sclerosis.

Adult↗
PubMed1996

Isolated optic neuritis and its prognosis for multiple sclerosis: a clinical and paraclinical study with evoked potentials. CSF examination and brain MRI.

Our study evaluated the frequency of developing multiple sclerosis (MS) after acute isolated optic neuritis (ON), the possible association with risk factors (gender, age), and the diagnostic and prognosis role of paraclinical tests. We studied 100 ON patients (mean age 28.9 years: SD 8.9): 85 patients were regularly followed up. Sixty-six patients underwent multimodality evoked potential (EP) test, examination and brain MRI within six months of the onset of ON. Over a mean follow-up of 5.2 years, MS occurred in 28/85 cases. The risk of developing MS after four years was 0.35 at life-table analysis, regardless of gender or age at the onset of ON. Visual EPs in unaffected eyes were abnormal in 25.4%, brainstem auditory EPs in 6.5% somatosensory EPs in 8.1%, upper limb motor EPs in 6.8% of the tested patients; intrathecal IgG synthesis was revealed in 51.7% and MRI lesions in 73.8%. Fifty-one of the patients who underwent paraclinical tests were followed up for more than one year, and MS occurred in 13 cases. All of these presented MRI lesions, nine intrathecal IgG synthesis, and two abnormal extraocular EPs. The risk of developing MS after four years was 0.33 in patients with MRI lesions; the simultaneous presence of intrathecal IgG synthesis increased the risk to 0.46.

Adult↗
PubMed1994

Optic neuritis: findings on MRI, CSF examination and HLA class II typing in 60 patients and results of a short-term follow-up.

Optic neuritis (ON) is a common first manifestation of multiple sclerosis (MS), and examination of patients with ON provides opportunities to study the early clinical stages of MS. This prospective study compares results of brain magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) examinations and HLA-Dw2 phenotyping in 60 consecutive patients with ON. At a median of 17 days after the onset of ON, 69% had oligoclonal IgG bands, and at a median on 79 days after onset, 53% had multiple (> or = 3) white matter lesions on MRI. Subgroup analyses revealed that MRI abnormalities and oligoclonal IgG bands were equally common in patients examined early or late after the onset of ON. Strong correlations were found between the presence of MRI abnormalities and oligoclonal IgG bands. The HLA-Dw2 phenotype was significantly increased in ON patients compared with controls, but also significantly different from a group of MS patients from the same geographical area. A significant relation was found between Dw2 phenotype and oligoclonal IgG bands. During a mean follow-up time of about 2 years, the diagnosis in 17 of the patients changed to clinically definite MS. Initially, 16 of them had oligoclonal IgG bands and 12 had three or more MRI lesions. Both MRI and CSF studies are important diagnostic tools in the workup of ON patients.

Adolescent↗
PubMed1997

Retrobulbar optic neuritis after pamidronate administration in a patient with a history of cutaneous porphyria.

We describe the case of a patient who developed reversible retrobulbar optic neuritis after intravenous pamidronate therapy for established osteoporosis. This possible complication has never been previously reported and, since our patient had a history of porphyria, it suggests that bisphosphonates should be administered cautiously in patients with this disease.

Anti-Inflammatory Agents↗
PubMed1995

The clinical and paraclinical profile of optic neuritis: a prospective study.

To define the clinical and paraclinical profile of optic neuritis (ON), patients with a suspicion of ON among a population of 1.5 million were examined over 2.5 years. A diagnosis of monosymptomatic ON was established in 74 patients. Cerebrospinal fluid (CSF) studies in 73 patients revealed oligoclonal IgG bands in 67% and 32 of 60 patients examined (53%) had three or more high signal lesions on magnetic resonance imaging (MRI). A strong correlation was found between oligoclonal bands and abnormal MRI. In 52 patients, two or more CSF examinations revealed strong variations in individual patients for mononuclear cell count and IgG index. In contrast, of 39 patients with oligoclonal bands in the first sample, none showed the disappearance of bands, and of 13 patients initially negative for bands, only one developed bands. There was no correlation between exacerbation or remission and CSF findings. During a short-term follow-up of 6-40 months, 19 patients converted to MS.

Adult↗
PubMed1994

Migrant sensory neuritis associated with AIDS: case report.

We studied an AIDS patient who suffered from numbness, paresthesias and pain in the territories of different non-contiguous cutaneous nerves at different times. A transitory partial loss of touch and pinprick sensibility was also present in the same cutaneous areas. Sensory conduction velocities and SAP amplitudes were normal. The clinical picture was consistent with the Migrant Sensory Neuritis of Wartenberg. This rare neuropathy has never previously been described in patients affected by AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1987

An X-ray diffraction study of changes in myelin structure during experimental allergic neuritis.

In order to determine whether the structure of the myelin membranes is modified during experimental allergic neuritis (EAN), we have performed X-ray diffraction studies of in vivo and of isolated sciatic nerves from Lewis rats exposed to different EAN-producing treatments. We have observed a decrease of the intensities in the X-ray reflections without changes in spatial resolution. The level of decrease correlated with the severity of the demyelinating lesions. In comparison to nerves from normal healthy rats the electron density profile of sciatic nerve myelin from animals in acute stages of EAN showed small differences at both cytoplasmic and extracellular spaces of the myelin membrane. Dynamic X-ray diffraction patterns recorded kinetically in vivo from a nerve injected intraneurally with a neuritogenic antiserum do not show additional reflections characteristic of a distinct lattice of increased periodicity, suggesting that the early stages of demyelination do not involve an intermediate ordered state.

Animals↗
PubMed1985

Amino acid and protein metabolism in dorsal root ganglia of rabbits with experimental allergic neuritis.

Amino acid and protein metabolism has been studied in the dorsal root ganglia of rabbits with experimental allergic neuritis (EAN). The concentrations of a number of nonessential amino acids (glutamine, serine, aspartate, and glutamate) were reduced in the spinal ganglia of EAN animals without any comparable change in the blood plasma. The short-term influx of glycine and GABA was decreased in EAN animals, whereas that of histidine and valine was not altered. The prolonged accumulation of all the four amino acids was unchanged. These results suggest alterations in the cell metabolism of the dorsal root ganglia, rather than unspecific changes in cellular permeability. Furthermore, incorporation of tritiated valine, histidine, and glycine into proteins of EAN-ganglia in vitro was significantly increased. Autoradiography of the protein-bound [3H]-valine indicated alterations in the protein synthesis of the ganglion neurons: A decreased grain density was found in ganglion neurons of EAN animals. The increased grain densities in the affected ganglia were observed in macrophages, and possible in activated Schwann cells, over the demyelinated spots. The results suggest intraneuronal changes in the dorsal root ganglia of amino acid and protein metabolism, possibly in response to peripheral axonal injury and/or to nonspecific cytotoxic effect of active lymphocytes and macrophages.

Amino Acids↗
PubMed1981

Hemiplegia and retrobulbar neuritis after subarachnoid block.

A 25 year old man was given a subarachnoid anaesthetic for repair of hydrocele. He developed left-sided hemiplegia and retrobulbar neuritis three hours after the procedure. He recovered 45 days later after steroid therapy. There was some residual neurological deficit. The differential diagnosis is discussed.

Adult↗