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Progressive visual loss: an unusual presentation of multiple sclerosis
S J Read1, J D Harrison, M P Pender
1Department of Neurology Royal Brisbane Hospital Australia.
Summary
Multiple sclerosis (MS) can uncommonly present with progressive visual loss. Diagnosis requires excluding other causes and confirming MS evidence, including lesions and cerebrospinal fluid findings.
Area of Science:
- Neurology
- Ophthalmology
Background:
- Progressive visual loss is an uncommon initial symptom of multiple sclerosis (MS).
- Differential diagnosis for visual impairment is broad, necessitating careful evaluation.
Purpose of the Study:
- To highlight the unusual presentation of multiple sclerosis with progressive visual loss.
- To emphasize diagnostic criteria for MS in such cases.
Main Methods:
- Case series of three patients presenting with progressive visual loss.
- Exclusion of alternative etiologies for visual impairment.
- Magnetic resonance imaging (MRI) for detecting CNS lesions.
- Cerebrospinal fluid (CSF) analysis for oligoclonal IgG bands.
Main Results:
- All three patients were diagnosed with MS after other causes were excluded.
- Two patients had extracranial neurological signs.
- MRI revealed lesions consistent with MS outside the visual pathways in all cases.
- CSF analysis showed oligoclonal IgG bands in two patients.
Conclusions:
- Multiple sclerosis should be considered in the differential diagnosis of progressive visual loss.
- Diagnosis requires exclusion of common causes and definitive evidence of MS.
- Extracranial lesions on MRI and CSF findings support MS diagnosis.
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