Optic Neuritis in Acute Disseminated Encephalomyelitis.

Lee, Jun Mo; Shin, In Ha; Seo, Kyoung Yul

Case Report

Journal of the Korean Ophthalmological Society 2003;44(5):1237-1241.
Published online May 1, 2003.

Optic Neuritis in Acute Disseminated Encephalomyelitis.

¹Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. seoky@yumc.yonsei.ac.kr
²The Institute of Vision Research, Korea.

급성산재성뇌척수염(Acute disseminated encephalomyelitis)에 의한 시신경염 1예

이준모 ( Jun Mo Lee ) , 신인하 ( In Ha Shin ) , 서경률 ( Kyoung Yul Seo )

Abstract

PURPOSE
This case is the first report of optic neuritis following acute disseminated encephalomyelitis in Korean literature and we report this case with a successful result of conservative treatment. METHODS: We examined a 7-year and-7-month-old female patient who visited our ophthalmology clinic complaining of a headache and visual disturbance in both eyes. At the time of visit, light perception was negative in both eyes, response to light reflex was nil in the right eye and weak in the left eye. Relative afferent papillary defect (RAPD) was noted in both eyes, and the disc swelling was found in both eyes on fundus examination. MRI brain scans revealed asymmetrical multifocal lesions involving the cortex and subcortex in the bilateral brain hemispheres, and contrast enhanced in T2-weighted images. Cerebrospinal fluid (CSF) examination showed results of 45 WBC, 10 polynuclear lymphocyte, and 88 monocyte cells/mm3. RESULTS: As patient was diagnosed with acute disseminated encephalomyelitis, she was prescribed intravenous steroid pulse therapy with methylprednisolone sodium succinate (Solu-medrol(R), Pharmacia, U.S.A), and immunoglobulin (Liv gamma(R), Green Cross, Korea). Seven days of steroid therapy was followed by tapering with oral steroid. Uncorrected vision was 0.9 in the right eye and 0.9 in the left. RAPD was resolved in both eyes. Visual evoked potentials showed both eyes being normal.

Key Words: Acute disseminated encephalomyelitis (ADEM);Multiphasic disseminated encephalomyelitis (MDEM);Multiple sclerosis;Optic neuritis