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Bilateral optic neuritis with spine demyelination associated with influenza A H1N1 infection
Selvakumar Ambika1, Padma Lakshmi1, Olma Veena Noronha2
1Department of Neuro-ophthalmology, Sankara Nethralaya- A unit of Medical Research Foundation, 18 College Road, Nungambakkam, Chennai, 600 006, India.
Purpose:
To report a rare case of optic neuritis with spine demyelination following H1N1 virus infection.
Observation:
A 66-year-old female presented with decreased vision in both eyes (left > right) following a recent episode of fever and flu. She was diagnosed as H1N1 infection confirmed by viral antigen analysis of throat swab. On examination, she had a profound vision drop in the left eye with optic disc edema. MRI brain and orbit revealed bilateral optic nerve and frontal dural thickening with a ring-enhancing lesion in the right frontal lobe. MRI spine showed long cord signals at T1-T7 suggestive of demyelination. The patient had a complete recovery of vision and visual fields after intravenous and oral steroids.
Conclusion/Importance:
Influenza A virus can manifest with a wide range of symptoms including flu-like illness to neurological complications. This case highlights optic neuritis as a presenting feature of H1N1 infection.
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