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[Retrobulbar optic nevritis and chicken pox: a case report in a child]
V Roelandt1, L Fayol, C Hugonenq
1Service de neurologie pédiatrique, hôpital d'enfants, CHU de la Timone, 13385 Marseille, cedex 05, France.
Abstract:
We report here the case of a three-year-old boy presenting with an optic neuritis during the invasive phase of a chicken pox. This clinical, infrequent picture, can be directly due to the virus or be secondary to an auto-immune mechanism. The examination of the ocular fundus, the profile of the spinal fluid, the MRI and the measure of visual evoked potential allow to reach diagnosis and to identify the type of lesion. There is no consensus on the treatment of this optic neuritis and the current attitude is therapeutic abstention because of a rapid spontaneous improvement. Cerebellitis, meningitis can also be seen during chicken pox. Their evolution is quickly favorable, not requiring additional exam. Encephalitis can result from an auto-immune lesion of the white matter and require then the use of corticoids with antiviral drugs.
Insights
Chickenpox can cause optic neuritis in children, a rare condition potentially linked to the virus or an autoimmune response. Diagnosis involves various tests, with treatment often favoring observation due to spontaneous recovery.
Area of Science:
- Ophthalmology
- Pediatrics
- Infectious Diseases
Background:
- Chickenpox (varicella-zoster virus infection) is common in children.
- Neurological complications, though rare, can occur during the invasive phase of chickenpox.
Observation:
- A three-year-old boy developed optic neuritis during an active chickenpox infection.
- Clinical presentation, cerebrospinal fluid analysis, MRI, and visual evoked potentials were used for diagnosis.
Findings:
- Optic neuritis in this case could be directly viral or secondary to an autoimmune mechanism.
- No established treatment consensus exists; therapeutic abstention is common due to rapid spontaneous improvement.
- Other neurological complications like cerebellitis and meningitis can occur but typically resolve favorably.
Implications:
- This case highlights the importance of considering optic neuritis in children with chickenpox.
- Understanding the potential autoimmune basis is crucial for managing similar cases.
- Further research may clarify optimal management strategies for post-varicella optic neuritis.
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