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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1984 Mar;47(3):241–249. doi: 10.1136/jnnp.47.3.241

Central nervous system involvement in optic neuritis.

E A Sanders, J P Reulen, L A Hogenhuis
PMCID: PMC1027721  PMID: 6707669

Abstract

Thirty patients with clinically uncomplicated optic neuritis were subjected to a battery of electrophysiological tests, including visual evoked response (VER), auditory brainstem evoked response (ABER) and somatosensory evoked response (SSER). Blink reflex, electronystagmography (ENG), and computed tomography examinations were also carried out on all patients. These non-invasive tests indicated that in 11 of the 30 patients (37%), the optic neuritis was a symptom of subclinical multiple sclerosis, and that another five patients showed signs of mild central nervous system (CNS) involvement which may develop into multiple sclerosis later. This was confirmed by cerebrospinal fluid (CSF) analysis, using isoelectric focusing, showing oligoclonal extra bands in 11 out of these sixteen. A new classification of optic neuritis is proposed on the basis of these findings.

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Selected References

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  1. Aita J. F., Bennett D. R., Anderson R. E., Ziter F. Cranial CT appearance of acute multiple sclerosis. Neurology. 1978 Mar;28(3):251–255. doi: 10.1212/wnl.28.3.251. [DOI] [PubMed] [Google Scholar]
  2. Asselman P., Chadwick D. W., Marsden D. C. Visual evoked responses in the diagnosis and management of patients suspected of multiple sclerosis. Brain. 1975 Jun;98(2):261–282. doi: 10.1093/brain/98.2.261. [DOI] [PubMed] [Google Scholar]
  3. Cala L. A., Mastaglia F. L., Black J. L. Computerized tomography of brain and optic nerve in multiple sclerosis. Observations in 100 patients, including serial studies in 16. J Neurol Sci. 1978 May;36(3):411–426. doi: 10.1016/0022-510x(78)90048-5. [DOI] [PubMed] [Google Scholar]
  4. Cohen M. M., Lessell S., Wolf P. A. A prospective study of the risk of developing multiple sclerosis in uncomplicated optic neuritis. Neurology. 1979 Feb;29(2):208–213. doi: 10.1212/wnl.29.2.208. [DOI] [PubMed] [Google Scholar]
  5. Delmotte P. Gel isoelectric focusing of cerebrospinal fluid proteins: a potential diagnostic tool. Z Klin Chem Klin Biochem. 1971 Jul;9(4):334–336. doi: 10.1515/cclm.1971.9.4.334. [DOI] [PubMed] [Google Scholar]
  6. Gyldensted C. Computer tomography of the brain in multiple sclerosis. A radiological study of 110 patients with special reference to demonstration of cerebral plaques. Acta Neurol Scand. 1976 May;53(5):386–389. doi: 10.1111/j.1600-0404.1976.tb04356.x. [DOI] [PubMed] [Google Scholar]
  7. HYLLESTED K., MOLLER P. M. Follow-up on patients with a history of optic neuritis. Acta Ophthalmol (Copenh) 1961;39:655–662. doi: 10.1111/j.1755-3768.1961.tb00280.x. [DOI] [PubMed] [Google Scholar]
  8. Halliday A. M., McDonald W. I., Mushin J. Delayed visual evoked response in optic neuritis. Lancet. 1972 May 6;1(7758):982–985. doi: 10.1016/s0140-6736(72)91155-5. [DOI] [PubMed] [Google Scholar]
  9. Haughton V. M., Ho K. C., Williams A. L., Eldevik O. P. CT detection of demyelinated plaques in multiple sclerosis. AJR Am J Roentgenol. 1979 Feb;132(2):213–215. doi: 10.2214/ajr.132.2.213. [DOI] [PubMed] [Google Scholar]
  10. Hutchinson W. M. Acute optic neuritis and the prognosis for multiple sclerosis. J Neurol Neurosurg Psychiatry. 1976 Mar;39(3):283–289. doi: 10.1136/jnnp.39.3.283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Ikuta F., Zimmerman H. M. Distribution of plaques in seventy autopsy cases of multiple sclerosis in the United States. Neurology. 1976 Jun;26(6 Pt 2):26–28. doi: 10.1212/wnl.26.6_part_2.26. [DOI] [PubMed] [Google Scholar]
  12. Jewett D. L., Williston J. S. Auditory-evoked far fields averaged from the scalp of humans. Brain. 1971;94(4):681–696. doi: 10.1093/brain/94.4.681. [DOI] [PubMed] [Google Scholar]
  13. Kjaer M. Evoked potentials. With special reference to the diagnostic value in multiple sclerosis. Acta Neurol Scand. 1983 Feb;67(2):67–89. doi: 10.1111/j.1600-0404.1983.tb04547.x. [DOI] [PubMed] [Google Scholar]
  14. Leibowitz U., Alter M., Halpern L. Clinical studies of multiple sclerosis in Israel. IV. Optic neuropathy and multiple sclerosis. Arch Neurol. 1966 May;14(5):459–466. doi: 10.1001/archneur.1966.00470110003001. [DOI] [PubMed] [Google Scholar]
  15. Mancini G., Carbonara A. O., Heremans J. F. Immunochemical quantitation of antigens by single radial immunodiffusion. Immunochemistry. 1965 Sep;2(3):235–254. doi: 10.1016/0019-2791(65)90004-2. [DOI] [PubMed] [Google Scholar]
  16. Matthews W. B., Small D. G., Small M., Pountney E. Pattern reversal evoked visual potential in the diagnosis of multiple sclerosis. J Neurol Neurosurg Psychiatry. 1977 Oct;40(10):1009–1014. doi: 10.1136/jnnp.40.10.1009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Neetens A., Hendrata Y., van Rompaey J. Pattern and flash visual evoked responses in multiple sclerosis. J Neurol. 1979 Mar 22;220(2):113–124. doi: 10.1007/BF00313952. [DOI] [PubMed] [Google Scholar]
  18. Nikoskelainen E., Frey H., Salmi A. Prognosis of optic neuritis with special reference to cerebrospinal fluid immunoglobulins and measles virus antibodies. Ann Neurol. 1981 Jun;9(6):545–550. doi: 10.1002/ana.410090606. [DOI] [PubMed] [Google Scholar]
  19. Oepen G., Brauner C., Doerr M., Thoden U. Visual evoked potentials (VEP) elicited by checkerboard versus foveal stimulation in multiple sclerosis. A clinical study in 235 patients. Arch Psychiatr Nervenkr (1970) 1981;229(4):305–313. doi: 10.1007/BF01833159. [DOI] [PubMed] [Google Scholar]
  20. Ongerboer de Visser B. W., Goor C. Electromyographic and reflex study in idiopathic and symptomatic trigeminal neuralgias: latency of the jaw and blink reflexes. J Neurol Neurosurg Psychiatry. 1974 Nov;37(11):1225–1230. doi: 10.1136/jnnp.37.11.1225. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Radue E. W., Kendall B. E. Iodide and xenon enhancement of computed tomography (CT) in multiple sclerosis (MS). Neuroradiology. 1978 May 31;15(3):153–158. doi: 10.1007/BF00329059. [DOI] [PubMed] [Google Scholar]
  22. Reulen J. P., Sanders E. A., Hogenhuis L. A. Eye movement disorders in multiple sclerosis and optic neuritis. Brain. 1983 Mar;106(Pt 1):121–140. doi: 10.1093/brain/106.1.121. [DOI] [PubMed] [Google Scholar]
  23. Richey E. T., Kooi K. A., Tourtellotte W. W. Visually evoked responses in multiple sclerosis. J Neurol Neurosurg Psychiatry. 1971 Jun;34(3):275–280. doi: 10.1136/jnnp.34.3.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Robinson K., Rudge P. Abnormalities of the auditory evoked potentials in patients with multiple sclerosis. Brain. 1977 Mar;100(Pt 1):19–40. doi: 10.1093/brain/100.1.19. [DOI] [PubMed] [Google Scholar]
  25. Robinson K., Rudge P. Auditory evoked responses in multiple sclerosis. Lancet. 1975 May 24;1(7917):1164–1166. doi: 10.1016/s0140-6736(75)93138-4. [DOI] [PubMed] [Google Scholar]
  26. Sandberg-Wollheim M. Optic neuritis: studies on the cerebrospinal fluid in relation to clinical course in 61 patients. Acta Neurol Scand. 1975 Sep;52(3):167–178. doi: 10.1111/j.1600-0404.1975.tb05771.x. [DOI] [PubMed] [Google Scholar]
  27. Sandberg M., Bynke H. Cerebrospinal fluid in 25 cases of optic neuritis. Acta Neurol Scand. 1973;49(4):443–452. doi: 10.1111/j.1600-0404.1973.tb01317.x. [DOI] [PubMed] [Google Scholar]
  28. Scarpalezos S., Tsakanikas C., Stamboulis E. Apport de l'épreuve vestibulaire rotatoire pendulaire au diagnostic de la forme spinale de la sclérose en plaques. Rev Neurol (Paris) 1981;137(2):147–151. [PubMed] [Google Scholar]
  29. Small D. G., Matthews W. B., Small M. The cervical somatosensory evoked potential (SEP) in the diagnosis of multiple sclerosis. J Neurol Sci. 1978 Feb;35(2-3):211–224. doi: 10.1016/0022-510x(78)90004-7. [DOI] [PubMed] [Google Scholar]
  30. Yates S. K., Brown W. F. Light-stimulus-evoked blink reflex: methods, normal values, relation to other blink reflexes, and observations in multiple sclerosis. Neurology. 1981 Mar;31(3):272–281. doi: 10.1212/wnl.31.3.272. [DOI] [PubMed] [Google Scholar]

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