Optic neuropathy demyelinating

The most common cause of primary demyelination is MS, so demyelinating optic neuropathy is often associated with MS. Other conditions have been implicated in demyelinating optic neuropathy, including acute transverse myelitis, acute disseminated encephalomyelitis, herpes zoster, Gnillain-Barre syndrome, Devic s nemomyelitis optica, Epstein-Barr virus, Charcot-Marie-Tooth syndrome, and chronic multifocal demyelinating nemopathy. 

Characteristics of the vision loss can aid in the diagnosis of demyelinating optic neuropathy. The vision loss is progressive, is maximal in 1 week, and achieves variable recovery within 4 to 6 weeks. The reduction in vision frequently is accompanied or preceded by periocular pain on movement of the eye. Color vision often is severely impaired, and visual fields most commonly reveal a relative central scotoma. The ophthalmoscopic picture is usually one of a normal optic nerve head, because most commonly the optic neuropathy is behind the globe and thus is called retrobulbar optic neuritis. When there is optic disc swelling, it is known as papillitis. 

Electrodiagnostic testing may be useful in the diagnosis of demyelinating optic neuropathy. The visual evoked potential shows a delayed peak latency amplitude in MS patients. 

MS), which is a demyelinating disorder. When optic neuritis occurs without disc swelling, the condition is called retrobulbar neuritis. When disc swelling is associated with optic neuritis, the condition is called papillitis. Papilledema is bilateral disc edema associated with increased intracranial pressure OCP). Optic atrophy, the end stage of many optic neuropathies, is characterized by a pale disc and associated with a relative afferent pupillary defect (RAPD) and possible loss of visual acuity, color vision, and visual field. One example of disc atrophy occurs in cases of Leber s hereditary optic neuropathy... 

In patients suspected of having demyelinating disease, laboratory testing may be beneficial. Testing of the CSF may reveal oligoclonal IgG bands consistent with MS. Minor pleocytosis may occur. In addition, an increase in the IgG index and oligoclonal bands is of value in the differential diagnosis. Elevated titers of antimyelin basic protein are also correlated with acute idiopathic optic neuropathy and relapses of MS. 

Ophthalmic examination showed anterior optic neuropathy in all three patients and MRI scanning ruled out demyelinating optic neuritis. In one patient an additional infusion of infliximab produced similar symptoms in the previously unaffected eye vision failed to improve despite infliximab withdrawal and steroid treatment. 

Optic neuropathy (axonal degeneration, primary demyelination) extrapyramidal syndrome (necrosis of putamen) retinopathy (edema)... 

Indications Alzheimer s dementia, cardiovascular disease, cerebrovascular disease, demyelination, depression, Friedreich s ataxia, improving memory, Leber s hereditary optic neuropathy Category Coenzyme Q10 analog Half-life N/A... 

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