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[Optic neuritis. A common first manifestation of multiple sclerosis]
1Neurologisk afdeling, Amtssygehuset i Glostrup.
Ugeskrift for Laeger
|March 4, 1996
Summary
Acute monosymptomatic optic neuritis (ON) is typically an early sign of multiple sclerosis (MS). Advanced tests like MRI and CSF analysis confirm this link, even before symptoms appear.
Area of Science:
- Neuroscience
- Immunology
Context:
- Acute monosymptomatic optic neuritis (ON) presents a diagnostic challenge, often considered either a distinct entity or an initial symptom of multiple sclerosis (MS).
- Understanding the relationship between ON and MS is crucial for early diagnosis and management.
Purpose:
- To clarify whether acute monosymptomatic ON is a separate disease or an early manifestation of MS.
- To investigate the association between ON and MS using paraclinical tests in a cohort of untreated patients.
Summary:
- Review of literature and examination of 50 untreated ON patients with paraclinical tests (MRI, neurophysiology, CSF) indicate monosymptomatic ON is usually an early MS manifestation.
- The HLA-DR15 tissue type is associated with both ON and MS. Unenhanced MRI lesions suggest the disease process may precede ON symptoms.
- Bilateral ON is not a strong predictor of MS. Subtle visual disturbances require sensitive evaluation beyond visual acuity to detect new attacks.
Impact:
- This study reinforces that monosymptomatic ON often signifies early-stage MS, necessitating comprehensive diagnostic approaches.
- Findings highlight the importance of advanced neuroimaging and neurophysiological assessments for early MS detection in ON patients.
- Emphasizes the need for sensitive evaluations to detect subtle visual changes indicative of MS progression.