[Two early-childhood cases of optic neuritis]

Area of Science:

• Neurology
• Pediatrics
• Ophthalmology

Background:

• Acute optic neuritis (ON) is an inflammatory condition affecting the optic nerve.
• Early-childhood demyelinating disorders present diagnostic challenges.
• Understanding the spectrum of ON and its relation to multiple sclerosis (MS) in young children is critical.

Observation:

• Two cases of early-childhood ON are presented: a 3-year-old girl and a 2-year-old boy.
• Case 1 experienced relapsing ON following an upper respiratory infection, with MRI showing white matter lesions, leading to probable MS diagnosis.
• Case 2 presented with acute visual disturbance and MRI evidence of optic nerve and white matter involvement.

Findings:

• Childhood ON can be associated with broader central nervous system demyelination.
• MRI findings in early-childhood ON may reveal silent brain lesions.
• The spectrum of demyelinating disorders may bridge ON and MS even in very young children.

Implications:

• Pediatric ON cases warrant careful neurological monitoring for potential MS development.
• Identifying subclinical brain involvement in childhood ON is essential for prognosis.
• This highlights the importance of considering MS in the differential diagnosis of acute visual disturbances in young children.