Recurrent Optic Neuritis and Perineuritis Followed by an Unexpected Discovery: From the National Multiple Sclerosis Society Case Conference Proceedings

We describe a woman with a history of relapsing acute optic neuritis and perineuritis. Testing failed to confirm a specific diagnosis; hence, she was diagnosed with seronegative neuromyelitis optica spectrum disorder and treated with the immunotherapy rituximab, later in conjunction with mycophenolate mofetil. She achieved a durable remission for 9 years until she presented with paresthesia affecting her left fifth digit, right proximal thigh, and left foot, while also reporting a 25-pound weight loss over the prior 3 months. New imaging demonstrated a longitudinally extensive and enhancing optic nerve, in conjunction with multifocal enhancing lesions within the spinal cord, in a skip-like distribution. The differential diagnosis is discussed.

Source: Neurology Neuroimmunology and Neuroinflammation - November 10, 2022 Category: Neurology Authors: Pimentel Maldonado, D. A., Lisak, R., Galetta, S., Balcer, L., Varkey, T., Goodman, A., Graves, J., Racke, M., Zamvil, S. S., Newsome, S., Frohman, E. M., Frohman, T. C. Tags: Diagnostic [amp ] Treatment Challenges Source Type: research