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Immune responses in experimental allergic neuritis.

The antibody and cell mediated immune responses were investigated in inbred Lewis rats with experimental allergic neuritis (EAN) induced by either P2, a protein purified from the bovine cauda equina nerve roots, or whole bovine nerve root myelin. In the P2 immunised animals both antibodies to P2 detected by radioimmunoassay and cell-mediated immunity to P2 assayed by skin testing appeared before the onset of EAN and persisted during and after the disease. In the myelin immunised animals the antibody titres were lower and somewhat delayed and the skin tests became negative at the height of the disease. Complement-fixing antibodies to galactocerebroside, which have been implicated in the production of demyelination under some circumstances, could not be detected in the serum after immunisation with either P2 or myelin. EAN was transferred passively with lymph node cells from rats immunised with either P2 or myelin although anti-P2 antibodies could not be detected in the serum of recipients with EAN. The results favour a cell-mediated immune response to P2 as the most important pathogenetic mechanism in EAN induced wtih whole myelin in the rat.

Animals↗

The migrant sensory neuritis of Wartenberg.

Six cases are reported that conform to Wartenberg's description of migrant sensory neuritis. This is a benign relapsing and remitting condition in which pain and subsequent loss of sensation in the distribution of individual cutaneous nerves is induced by movement of the limbs inducing stretch. Sural nerve biopsy in one case showed loss of large myelinated fibres, axonal sprouting and some changes suggestive of ischaemia.

Adult↗

Transient visually evoked potentials to sinusoidal gratings in optic neuritis.

Transient visually evoked potentials (VEPs) to sinusoidal gratings over a range of spatial frequencies have been recorded in cases of optic neuritis. The use of the response to pattern onset in addition to the response to pattern reversal extended the range to higher spatial frequencies by up to two octaves. There was an increase in VEP delay and a greater degree of discrimination from a control group at higher spatial frequencies. This finding is discussed in the light of previous reports of luminance and checkerboard VEPs in demyelinating optic nerve disease. An attempt is made to relate amplitude changes in various VEP components to contrast sensitivity measurements in this group of patients.

Evoked Potentials, Visual↗

The early risk of multiple sclerosis after optic neuritis.

Serial brain MRI was performed in 53 patients with clinically isolated optic neuritis. Using clinical and imaging evidence for relapse, multiple sclerosis developed within a mean of 12 months in 19 of 34 cases (56%) with brain lesions at presentation, and in only 3 of 19 cases (16%) without (Relative Risk = 6.8, p less than 0.005).

Adolescent↗

Multiple sclerosis following optic neuritis in Chile.

Twenty three unselected cases of optic neuritis were re-examined between 2 and 18 years after the onset of the disease, with a mean of 9.7 years. Only 8/23 (35%) had unilateral non-recurrent disease. One patient only (4.3%) went on to develop multiple sclerosis. These findings support the impression that demyelinating disease varies considerably in Latin America compared with northern industrialised countries.

Adolescent↗

IgG immunoadsorption in experimental allergic neuritis: effect on antibody levels and clinical course.

The effect of IgG immunoadsorption upon the course of chronic experimental allergic neuritis (EAN) is described. Miniature membrane plasma separators coupled with a Protein A (PA)-Sepharose immunoadsorbent column were used to perform upon conscious rabbits 5 IgG immunoadsorption treatments over 6 days. Quantitation of anti-myelin IgG and IgM by ELISA revealed that 55-65% of plasma IgG was removed per treatment. Rapid post-treatment antibody rebound was observed for anti-myelin IgG although no antibody overshoot above control levels could be observed. Anti-myelin IgM levels remained relatively unaffected by PA immunoadsorption. Comparisons of clinical scores between control and treatment animals showed that IgG immunoadsorption was significantly beneficial (day 1 post-treatment p less than 0.001; day 2 post-treatment p less than 0.05). However, rapid relapse was observed in all treatment animals such that by day 3 post-treatment no significant clinical difference between control and treatment groups could be observed. IgG immunoadsorption suppresses the clinical progression of chronic EAN in a manner similar to that seen with plasma exchange. This finding suggests that antibody modulates early disease pathogenesis.

Animals↗

Patterns of conduction impairment in experimental allergic neuritis. An electrophysiological and histological study.

Electrophysiological and histological studies of peripheral nerve were performed in 24 Lewis rats with experimental allergic neuritis (EAN) in which disease had been induced by a single myelin and adjuvant inoculation in one footpad. Demyelination was demonstrated in transverse nerve sections from ventral roots, proximal sciatic nerves and also in distal plantar nerves. Histological and electrophysiological assessments showed that injected limbs were more affected than uninjected limbs. Neurophysiological studies demonstrated two distinct patterns of conduction failure based upon proximal/distal compound muscle action potential (CMAP) amplitude ratios in both uninjected and injected limbs. Slightly more than half of all nerve trunks showed a mildly reduced distal CMAP amplitude irrespective of stimulus origin. The rest displayed a more severe reduction of distal amplitude that was length-dependent, becoming smaller with proximal stimulation. Histological lesions in plantar nerves were often more severe than those in proximal sciatic nerves or ventral roots. Axonal degeneration was an uncommon finding. This study has demonstrated patterns of peripheral nerve conduction impairment similar to those reported in patients with inflammatory demyelinating neuropathy. Moreover, it has shown that a low distal CMAP amplitude may result from demyelination of distal motor nerve segments and not necessarily from axonal degeneration.

Animals↗

Optic neuritis and HIV-1 infection.

A patient is reported who developed acute optic neuritis in the context of severe immunodeficiency associated with HIV-1 infection. The clinical, laboratory, and radiological features are described and the possible associations with syphilis, multiple sclerosis, lymphoma, and HIV-1 infection are discussed.

Adult↗

Acute brachial neuritis (Parsonage-Turner syndrome): MR imaging appearance--report of three cases.

Magnetic resonance (MR) imaging findings in three patients with acute onset of neuritic shoulder pain and weakness included high signal intensity in supra- and infraspinatus muscles (n = 2), partial involvement of infraspinatus muscle (n = 1) and of deltoid muscle (n = 1), and atrophy of supra- and infraspinatus muscles (n = 2). Clinical diagnosis of acute brachial neuritis (Parsonage-Turner syndrome) correlated with MR imaging results in all cases.

Acute Disease↗

Optic neuritis and human T-lymphotropic virus type 1-associated myelopathy: a case report.

A 50-year-old woman with human T-lymphotropic virus type 1-associated myelopathy developed sudden loss of vision in her left eye. The patient had a relative afferent pupillary defect and a large central scotoma on visual field examination, but no abnormal findings were apparent upon slitlamp microscopy and funduscopic examination. A diagnosis of retrobulbar optic neuritis was made. We discuss the possible association of human T-lymphotropic virus type 1 infection.

Evoked Potentials, Visual↗

Retrobulbar optic neuritis and rhegmatogenous retinal detachment in a fourteen-year-old girl with retinitis pigmentosa sine pigmento.

A 14-year-old girl complained of a sudden decrease in right visual acuity. The patient had night blindness, a mottled retina but no pigments, extinguished scotopic electroretinographic response, central scotoma in the right eye and rhegmatogenous retinal detachment. She had initially received laser photocoagulation around the retinal tear and then corticosteroid therapy, cryoretinopexy and segmental buckling. Her right visual acuity increased to 1.0. The association of retinitis pigmentosa sine pigmento, retrobulbar optic neuritis and rhegmatogenous retinal detachment, as demonstrated in our patient, may be uncommon.

Adolescent↗

Progression of optic neuritis to multiple sclerosis: a prospective study in an Italian population.

We prospectively studied 40 patients with uncomplicated optic neuritis (ON) to determine the risk of subsequent multiple sclerosis (MS). All patients were followed for at least 12 years. Ten patients (25%) developed MS. Seven of these 10 patients developed MS within 2 years. Both sexes were at high risk if ON occurred between the ages of 21 and 40. There was an overall increased risk of MS with recurrent ON. The course of MS appeared to be fairly benign during the period of observation.

Adolescent↗

Optic neuritis and multiple sclerosis. Cell-mediated cytotoxicity by peripheral blood lymphocytes against basic protein of myelin, encephalitogenic peptide, cerebrosides and gangliosides.

On examination in the first weeks after onset of the disease, cell-mediated cytotoxicity against encephalitogenic peptide, myelin basic protein (MBP), cerebrosides and gangliosides was demonstrable in 32 (76%) of 42 patients with optic neuritis (ON). 14 patients with ON and concomitant neurological symptoms (ON/MS) had positive findings with all antigens, especially with the encephalitogenic peptide. The cytotoxic reactions against all antigens showed a close correlation with the course of ON: when the disease improved, the cytotoxicity decreased and became negative on average 4 months after ON onset. As previously reported, cell-mediated cytotoxicity against the above-mentioned antigens, especially the encephalitogenic peptide, may be considered as a pathogenetic factor in multiple sclerosis (MS). A positive reaction with this antigen in patients with ON only probably indicates the first manifestations of MS.

Adolescent↗

Occurrence of MRI abnormalities in patients with isolated optic neuritis.

24 patients with clinically isolated optic neuritis (ON) were examined with MRI. Only 5 patients (22.9%) had a normal MRI scan. The number of detected clinically silent lesions ranged from 0 to 38. They were mainly located in the frontal and parietal white matter. All patients with more than 3 lesions on MRI had pathological findings in CSF. There was no correlation between the number and location of lesions and age at onset of ON.

Adult↗

Effect of experimental allergic neuritis serum on normal rat peripheral nerve.

To study the possible in vivo activity of experimental allergic neuritis (EAN) serum, we injected serum from rats immunized with whole nerve, P2 protein or adjuvant alone into the sciatic nerve of normal Lewis rats. Serum from whole nerve and P2-immunized animals produced demyelination 24 h after injection. Only high-titer anti-P2 serum was active and no control serum had this effect. Anti-P2 antibodies or other serum factors may contribute to the pathogenesis of whole nerve and P2-induced EAN.

Animals↗

Evolution of the cellular response in P2-induced experimental allergic neuritis.

We examined the development of the inflammatory cellular response and demyelination in P2 protein-induced experimental allergic neuritis (EAN). Collections of inflammatory cells were first identified in nerve roots 14 days after immunization. Ia+ cells predominated in the evolving lesions and T-helper cells were the dominant T-cell type with T-suppressor/cytotoxic cells appearing later in the course of the disease. Vesiculation, the earliest change seen in the myelin sheath, appeared before the wave of cellular infiltration. These results indicate that myelin injury precedes inflammation in P2 protein-induced EAN, and provide further evidence that this disorder is indistinguishable from EAN induced with whole peripheral nerve myelin.

Animals↗

Multiple cranial neuritis associated with large granular lymphocytosis.

A patient with a unique form of large granular lymphocytosis and multiple cranial neuritis is reported. The patient presented with facial weakness, diplopia and dysarthria. An increase in large granular lymphocytes (LGLs) was seen in blood (1.8 x 10(9)/l), CSF (237/microliters) and bone marrow (20% in a normocellular bone marrow). The phenotype of the LGLs in CSF, blood and bone marrow was CD2+ CD3+ CD4+ CD8- CD16- CD56- and CD57-. The unique features of this case include the CD4+ phenotype, the relative abundance of CSF LGL and the clinical presentation.

Antigens, CD↗