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Updated: Jul 19, 2026

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
Published on: April 14, 2014
Isolated bilateral optic neuritis in acute disseminated encephalomyelitis
Regitze Bangsgaard1, Vibeke Andrée Larsen, Dan Milea
1Department of Ophthalmology, Glostrup University Hospital, Glostrup, Denmark. regitze@dadlnet.dk
A rare case of acute disseminated encephalomyelitis (ADEM) presented solely as isolated optic neuritis in a child, leading to visual loss. Prompt treatment with steroids and immunoglobulins resulted in significant visual recovery.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Neuroimmunology
Background:
- Acute disseminated encephalomyelitis (ADEM) is a rare, immune-mediated inflammatory disease of the central nervous system.
- Optic neuritis, inflammation of the optic nerve, can be a presenting symptom of various neurological conditions.
Observation:
- A 4-year-old girl experienced sudden, isolated bilateral visual loss.
- The visual loss was associated with bilateral optic nerve edema of unknown etiology, following a viral illness.
Findings:
- Cerebral MRI revealed bilateral optic nerve enhancement and diffuse white matter lesions, suggestive of ADEM.
- Treatment with intravenous steroids and immunoglobulins led to favorable visual recovery.
Implications:
- Childhood bilateral isolated optic neuritis can be the sole initial manifestation of ADEM.
- Early diagnosis and appropriate immunomodulatory therapy are crucial for visual outcome in pediatric ADEM presenting with optic neuritis.
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