Optic neuritis

Historical note and nomenclature
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Jean-Martin Charcot recorded the best early descriptions of optic neuritis. He reported an account of a woman with multiple sclerosis and feebleness of vision in 1835, illustrating a link between the 2 diseases (DeJong 1970). Sequin published the first American reports of "disseminated cerebrospinal sclerosis," including cases of optic neuritis with subacute transverse myelitis. A more detailed historical description, starting with Arabic texts in the ninth century that began to distinguish between eye paralysis and abnormal perception, is detailed by Volpe (Volpe 2001). Adie, Denny-Brown, and McAlpine all stated that unilateral retrobulbar neuritis was a symptom of multiple sclerosis (Kurtzke 1970). However, many patients with optic neuritis do not develop multiple sclerosis. This suggests there is a spectrum from a sole demyelinating episode, to a forme fruste of multiple sclerosis, to one of many signs of multiple sclerosis. Severe optic neuritis is part of neuromyelitis optica/Devic disease, but the pathogenesis is different from the multiple sclerosis-related idiopathic optic neuritis. This clinical article focuses on optic neuritis as an isolated demyelinating syndrome.

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited
Web resources