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[Immunoregulation disturbance in experimental allergic neuritis. The cellular and humoral mediated immunological damage].

The cellular and humoral mediated immune responses were investigated in the rabbits with experimental allergic neuritis (EAN) induced by the myelin basic protein (MBP) purified from the human sciatic nerve. The cellular mediated immunity to MBP were assayed by skin testing and lymphocytes transformation. The antibodies to myelin and muscle, the immunoglobulin deposits in the nerve and tissues respectively were detected by indirect and direct immunoenzyme assays. In rabbits with EAN, the skin tests became positive at the onset of EAN. There was a significantly higher index of the lymphocytes transformation in the EAN than in normal animals. At the height of the disease, the anti-muscle antibody titres were high. The granular deposits containing IgG were found in sciatic nerve and heart. The results favour cellular and humoral mediated immunological damage as the most important pathogenetic mechanism in EAN.

Animals↗

[Idiopathic brachial neuritis in a 12-year-old boy].

Idiopathic brachial neuritis (IPN) is a clinical entity of unknown cause characterized by sudden onset of pain and weakness with occasional atrophy of the arm muscles. It has rarely been documented in children. Many cases are preceded by upper respiratory tract infections, immunisations or trauma, which has led to speculation about an autoimmune cause. A case of severe IPN in a 12-year-old boy without antecedent events is presented. Diagnostic tests, treatment and prognosis are discussed.

Brachial Plexus Neuritis↗

[Disturbance of immunoregulation in experimental allergic neuritis in rabbits: II. The relationship between the changes in CSF and serum serotonin concentrations and immune responses].

The serotonin (5-HT) concentrations in the CSF and serum of the rabbits with experimental allergic neuritis (EAN) were determined. The relationships between the 5-HT concentrations and the rate of the specific lymphocyte transformation as well as that of the formation of the antimyelin antibody were investigated. The results indicated that after the rabbits were sensitized with myelin basic protein (MBP), the 5-HT levels in the CSF and serum of the rabbits with EAN increased. It was, therefore, considered that 5-HT might play a role in the inhibition of the lymphocyte transformation and the antibody production.

Animals↗

[Study on therapy of experimental autoimmune neuritis by bone marrow stromal cells].

AIM: To investigate the therapeutic effect of bone marrow stromal cells (BMSCs) transplantation on experimental autoimmune neuritis (EAN) and study the possible mechanism. METHODS: EAN model was established by immunizing Lewis rats with P(0)180-199 peptide and complete Freund's adjuvant (CFA). In the therapy group, BMSCs (2x10(6) cells/rat) were marked with fluorochrome PKH26 and injected into the rats' caudal vein 10 d after immunization. The therapeutic effect of BMSC transplantation on EAN rats was investigated by clinical assessment, immunohistochemical staining, and ELISA, respectively. RESULTS: The injected BMSCs could migrate to the demyelinated nerve tissues, and the demyelination and inflammatory infiltration was relieved. The infiltration of CD4(+) and CD8(+) T cells and the sera level of IFN-gamma and TNF-alpha were decreased significantly (P<0.05), whereas IL-4 level in the supernatant of cultured lymphocytes was increased (P<0.05). CONCLUSION: Certain therapeutic effect of BMSC transplantation on EAN was observed. BMSCs could reverse the disbalance of Th1/Th2 cells by regulating the cytokine expression and could inhibit the activation and proliferation of T cells.

Animals↗

[Effect of prednisolone on the course of optic neuritis. Results of a double-blind study].

The treatment of optic neuritis (ON) with corticosteroids has been controversial for many years. None of the previous studies with the usual dosage of steroids or ACTH has proven that this therapy is beneficial. However, these studies did not apply sensitive parameters for assessing the course of ON. The aim of this study was to examine the effect of corticosteroids using subtle parameters. The study design emphasized: 1. strict criteria for patient selection; 2. frequent controls during the initial period of the disease, follow-up for 1 year; 3. double-blind conditions with randomized groups; 4. assessment of the course with sensitive parameters, including visual acuity, visual evoked potentials (VEP) and the Tübingen Flikker Test, also called the Aulhorn Flicker Test, which monitors the activity of the ON. These last two tests were used for the first time in a controlled treatment study in ON. Thirty-eight patients with acute ON were treated orally in a double-blind procedure with either methylprednisolone (initially 100 mg daily, reduction every 3 days) or with vitamin B1 (100 mg thiamin daily) in the control group. The results of the Flicker Test and VEP showed a trend toward faster recovery under prednisolone within the first few weeks after onset of the disease. After 1 year none of the parameters examined showed any difference between the two groups. Thus, although prednisolone treatment in the dosage mentioned above seems to speed up recovery in the initial phase in some patients, no long-term benefit could be demonstrated.

Adult↗

[Monoparesis due to the brachial plexus neuritis by herpes zoster virus--report of a case].

A 73-year-old woman suffering from the acute onset monoparesis of her right arm which followed the skin eruption with mild sensory disturbance of right C4-6 level, was reported. Electrophysiological examinations revealed the brachial plexus neuritis and axonal degeneration of the proximal portion, with the evidence of herpes zoster infection. Her paresis of the right arm gradually improved without any medication during her hospital course. It was concluded that herpes zoster should be considered to be one of the causes of acute onset brachial plexopathy.

Aged↗

Bee sting optic neuritis. A case report with visual evoked potentials.

Simultaneous recordings of the pattern visual evoked potential and the pattern electroretinogram were recorded in a case of unilateral optic neuritis following a bee sting on the eye. The patient presented with severe eye pain, apoplectic visual loss, acute optic disc swelling and minimal signs of ocular inflammation and eyelid edema. The vision failed to recover. The electrophysiological recordings initially showed a delay in the P100 wave of the pattern visual evoked potential. On follow-up, a normal latency and amplitude of the P50 wave of the pattern electroretinogram was recorded with the flattening of the N95 component, but the pattern visual evoked potential was absent. The data suggests that the optic nerve was demyelinated acutely, and that subsequently axonal loss and degeneration of retinal ganglion cells occurred.

Adult↗

Bilateral optic neuritis following bacille Calmette-Guérin (BCG) vaccination.

A 12-year-old PPD-negative girl developed bilateral optic neuritis with decreasing visual acuity 5 days after bacille Calmette-Guérin (BCG) vaccination. Laboratory findings and computerized tomography scan of brain and orbit were negative. Cerebrospinal fluid study revealed 62 leukocytes (92% lymphocytes) per cubic millimeter and a protein level of 33 mg/dl. The patient was treated with systemic steroids. The vision returned to normal in 4 weeks and the disc edema resolved in 6 weeks without residual deficit. The complications of BCG are discussed.

BCG Vaccine↗

[Optic neuritis in children].

Study of 40 children who presented a first episode of idiopathic optic neuritis. A mean follow-up of more than 8 years revealed only 15% of multiple sclerosis. This frequency is much lower than in adults. The visual outcome is also better. Significant factors are: absence of papilloedema, unilaterality, recurrence, HLA B7 and DR2, oligoclonal cerebrospinal fluid, anomalies of the VEPs.

Adolescent↗

Contrast-enhanced MR imaging of optic nerve lesions in patients with acute optic neuritis.

The purpose of this study was to determine if administration of gadopentetate dimeglumine aids in the MR detection of optic nerve lesions in patients with acute optic neuritis and to establish an efficient MR imaging protocol to effectively demonstrate such lesions. Patients with acutely decreased visual acuity were referred for MR imaging of the brain and orbits. Predominantly, T1-weighted images were obtained in axial and coronal planes with and without contrast administration. Enhancing lesions were observed in the optic nerve (7/14 patients) and optic chiasm (2/14), and associated white matter lesions were seen elsewhere in the brain (5/19). Our results indicate that administration of gadopentetate dimeglumine aids in the MR detection of lesions of the optic nerve and optic chiasm. Applicability of our MR imaging protocol was confirmed by the demonstration of these lesions and by the disseminated white matter lesions seen simultaneously elsewhere in the brain.

Acute Disease↗

[Atypical forms of optic neuritis of multiple sclerosis].

The authors report seven cases of optic neuritis in patients with a diagnosis of multiple sclerosis. All patients had severe bilateral eye disease with no or incomplete recovery. Clinical signs and symptoms of multiples sclerosis were observed in only some patients. IRM was remarkably sensitive for detecting cerebral lesions and confirming the diagnosis. In every case visual field abnormalities consisted of a diffuse defect of sensitivity with pericentral scotoma. The authors emphasize on two atypical forms, total acute neuropathy and chronic primary neuropathy.

Acute Disease↗

Visual function after optic neuritis: a preliminary study.

We assessed visual function after recovery from optic neuritis in 15 consecutive patients using five objective tests: colour vision testing with Ishihara colour plates and with D15 colour desaturated spots, Humphrey automated perimetry, contrast acuity testing with Regan letter charts and testing of visual evoked response (VER). Recovery of visual function was not found to be dependent on presenting Snellen visual acuity or treatment with oral steroids. The most sensitive measures of residual visual deficit were mean defect on automated perimetry, low-contrast acuity and VER.

Adult↗

[The risk of multiple sclerosis development in patients with idiopathic optic neuritis: prognosis and other problems].

The percentage of patients with idiopathic optic neuritis (ION) developing multiple sclerosis (MS) was higher in young females who had recurrent ION, especially during 4 years since the first inflammatory attack. Clinical features of ION had no prognostic value. Patients with ION developed also more frequently MS if paraclinical findings showed the occurrence of DR2, DR3, DQw1 and/or DPw4, increased CSF IgG index, CSF oligoclonal IgG, asymptomatic lesions in NMR brain images, and subclinical abnormalities in visual, brainstem auditory, somatosensory evoked potentials. The author discusses the problem whether high risk patients with ION should be given antiviral and immunomodulatory drugs which could prevent or delay the clinical onset of MS.

Adult↗

Demyelinating optic neuritis: clinical features and differential diagnosis.

Optic neuritis is a common cause of sudden visual impairment in young adults. Early recognition by the clinician would alleviate much of the anxiety experienced by sufferers, but other conditions that may cause permanent blindness must be excluded. These can usually be discerned from the history and confirmed by a brief neuro-ophthalmological examination.

Color Perception↗

Corticosteroid therapy in optic neuritis (optic neuropathy).

Corticosteroid treatment of acute idiopathic optic neuritis is still highly controversial. Controlled studies have indicated that visual acuity has been restored more rapidly after corticoid treatment. Long-term results however do not differ with the untreated control group. Corticoids are essential in the treatment of ischemic optic neuropathy, especially when occurring with auto-immune diseases or giant cell arteritis. Some authors believe that corticoids can be helpful during the acute phase of an idiopathic anterior ischemic optic neuropathy.

Adrenal Cortex Hormones↗

The electrophysiological examination in acute optic neuritis and during their recovery.

A survey of the electrophysiological methods will be given. We use this method to diagnose an optic neuritis and to evaluate it during its acute stage as well as during its recuperation. The importance of the contrast as stimulation parameter of the pattern VEP will be described, and its clinical relevance will be illustrated by a few clinical cases.

Acute Disease↗

Gangliosides improve the outcome of experimental allergic neuritis (EAN).

The effect of gangliosides on the clinical expression of experimental allergic neuritis (EAN), a PNS counterpart of experimental allergic encephalomyelitis (EAE), was tested in Lewis rats sensitized with bovine intradural root myelin in complete Freund's adjuvant (CFA). A mixture of bovine brain gangliosides (GM1, GD1a, GD1b, GT1b) was injected intramuscularly at a daily dose of 20 mg per kg beginning 6 days post inoculation. The results show that GA treatment considerably reduces the incidence of mortality, delays its occurrence, and reduces the severity of clinical scores when either the whole population or survivors only are considered. Benefit from GA treatment appeared roughly proportional to disease severity. The neuronotrophic and anti-inflammatory effects possibly play a role in GA protecting effect.

Analysis of Variance↗

[Optic neuritis and sarcoidosis (author's transl)].

Case report of a sarcoidosis in a young west-indies feurale: ganglio-mediastinal and lung lesions, liver and salivary glands right optic nerve with retrobulbar optic neuritis. This lesions were quickly and totally reversible with tetracosactide and prednisone therapy.

Adult↗