Parainfectious optic neuritis and encephalomyelitis. A report of two cases with thalamic involvement.
Two children developed mental status alteration and bilateral profound visual loss secondary to optic neuritis. The clinical picture was consistent with parainfectious encephalomyelitis. Magnetic resonance imaging showed bilateral involvement of the thalamus in both cases. In one case the thalamic involvement was solitary and was suspected initially to represent a primary thalamic neoplasm. This was ruled out by a stereotactic biopsy of the thalamus, which showed perivascular inflammation consistent with parainfectious encephalomyelitis. The clinical and neuroimaging findings improved significantly following corticosteroid administration. Several relapses occurred upon initial attempts at corticosteroid cessation.
Hamed
L M
LM
Department of Ophthalmology, University of Florida, College of Medicine, Gainesville 32610-0284.
Silbiger
J
J
Guy
J
J
Mickle
J P
JP
Sibony
P
P
Cossari
A
A
Andriola
M
M
D002675:Child, Preschool; D003287:Contrast Media; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000009:adverse effects; D004492:Edetic Acid; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D009902:Optic Neuritis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D009942:Organometallic Compounds; D011055:Poliovirus Vaccine, Oral / Q000009:adverse effects; D013786:Thalamic Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
D003287:Contrast Media; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D005938:Glucocorticoids; D009942:Organometallic Compounds; D011055:Poliovirus Vaccine, Oral; C041365:gadolinium EDTA; D004492:Edetic Acid