Skip to main content

Advertisement

Log in

Optic neuritis presenting with amaurosis fugax

  • Letter to the Editors
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Optic neuritis usually presents with rapid and gradual loss of vision that is either complete or incomplete, and typically associated with retro-orbital pain. To our knowledge there have been no documented reports of optic neuritis presenting with multiple episodes of amaurosis fugax, the sudden and transient loss of vision lasting seconds to minutes. We report here the case of a young woman with a possible diagnosis of demyelinating left optic neuritis that presented solely with multiple episodes of brief and transient sudden loss of vision. Ophthalmological exams were normal between episodes of vision loss. The patient’s magnetic resonance imaging of the brain showed a subtle enhancement of the left optic nerve along with multiple periventricular lesions, highly suggestive of a demyelinating disease. The frequent episodes of visual loss resolved completely with high dose parenteral steroids. Neurologists and other clinicians should be aware of this unusual presentation of optic neuritis as treatment modalities differ greatly from other causes of amaurosis fugax.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

References

  1. Biousse V, Trobe JD (2005) Transient monocular visual loss. Am J Ophthalmol 140:717–722

    Article  PubMed  Google Scholar 

  2. Black JA, Felts P, Smith KJ, Kocsis JD, Waxman SG (1991) Distribution of sodium channels in chronically demyelinated spinal cord axons. Immuno-ultrastructural localization and electrophysiological observations. Brain Res 544:59–70

    Article  CAS  PubMed  Google Scholar 

  3. Boomer JA, Siatkowski RM (2003) Optic neuritis in adults and children. Semin Ophthalmol 18:174–180

    Article  PubMed  Google Scholar 

  4. Brex PA, Miszkiel KA, O’Riordan JI, Plant GT, Moseley IF, Thompson AJ, Miller DH (2001) Assessing the risk of early multiple sclerosis in patients with clinically isolated syndromes: the role of a follow up MRI. J Neurol Neurosurg Psychiatry 70:390–393

    Article  CAS  PubMed  Google Scholar 

  5. Fisher C (1989) ‘Transient monocular blindness’ versus ‘amaurosis fugax’. Neurology 39:1622–1624

    CAS  PubMed  Google Scholar 

  6. Flammer J, Pache M, Resink T (2001) Vasospasm, its role in the pathogenesis of diseases with particular reference to the eye. Prog Retin Eye Res 20:319–349

    Article  CAS  PubMed  Google Scholar 

  7. Glaser JS (1990) Topical diagnosis: prechiasmal visual pathways. In: Glaser JS (ed) Clinical neuroophthalmology, 2nd edn. Lippincott, Philadelphia, pp 83–170

    Google Scholar 

  8. Hill DL, Daroff RB, Ducros A, Newman NJ, Biousse V (2007) Most cases labeled as “retinal migraine” are not migraine. J Neuroophthalmol 27:3–8

    PubMed  Google Scholar 

  9. Rot U, Mesec A (2006) Clinical, MRI, CSF and electrophysiological findings in different stages of multiple sclerosis. Clin Neurol Neurosurg 108:271–274

    Article  PubMed  Google Scholar 

  10. Sadun AA, Currie JN, Lessel S (1984) Transient visual obscurations with elevated optic discs. Ann Neurol 16:489–494

    Article  CAS  PubMed  Google Scholar 

  11. Shahar E, Desatnik H, Brand N, Straussberg R, Hwang PA (1996) Epileptic blindness in children: a localizing sign of various epileptic disorders. Clin Neurol Neurosurg 98:237–241

    Article  CAS  PubMed  Google Scholar 

  12. Sharpless NS, Thal LJ, Perlow MJ, Tabaddor K, Waltz JM, Shapiro KN, Amin IM, Engel J Jr, Crandall PH (1984) Vasoactive intestinal peptide in the cerebrospinal fluid. Peptides 5:429–433

    Article  CAS  PubMed  Google Scholar 

  13. Smith KJ, McDonald WI (1999) The pathophysiology of multiple sclerosis: the mechanisms underlying the production of symptoms and the natural history of the disease. Philos Trans R Soc Lond B Biol Sci 354:1649–1673

    Article  CAS  PubMed  Google Scholar 

  14. Swanton JK, Rovira A, Tintore M, Altmann DR, Barkhof F, Filippi M, Huerga E, Miszkiel KA, Plant GT, Polman C, Rovaris M, Thompson AJ, Montalban X, Miller DH (2007) MRI criteria for multiple sclerosis in patients presenting with clinically isolated syndromes: a multicentre retrospective study. Lancet Neurol 6:677–686

    Article  PubMed  Google Scholar 

  15. The Amaurosis Fugax Study Group (1990) Current management of amaurosis fugax. Stroke 21:201–208

    Google Scholar 

  16. Waxman SG, Ritchie JM (1985) Organization of ion channels in the myelinated nerve fibers. Science 228:1502–1507

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amer M. Awad.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Awad, A.M., Estephan, B., Warnack, W. et al. Optic neuritis presenting with amaurosis fugax. J Neurol 256, 2100–2103 (2009). https://doi.org/10.1007/s00415-009-5302-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-009-5302-4

Keywords

Navigation