Relapsing White Matter Disease and Subclinical Optic Neuropathy From the National Multiple Sclerosis Society Case Conference Proceedings

  • Kimberly A. O'Neill
  • , Andrew Dugue
  • , Nicolas J. Abreu
  • , Laura J. Balcer
  • , Marc Branche
  • , Steven Galetta
  • , Jennifer Graves
  • , Ilya Kister
  • , Cynthia Magro
  • , Claire Miller
  • , Scott D. Newsome
  • , John Pappas
  • , Janet Rucker
  • , Connolly Steigerwald
  • , Christopher M. William
  • , Scott S. Zamvil
  • , Scott N. Grossman
  • , Lauren B. Krupp

Research output: Contribution to journalArticlepeer-review

Abstract

A 16-year-old adolescent boy presented with recurrent episodes of weakness and numbness. Brain MRI demonstrated subcortical, juxtacortical, and periventricular white matter T2 hyperintensities with gadolinium enhancement. CSF was positive for oligoclonal bands that were not present in serum. Despite treatment with steroids, IV immunoglobulins, plasmapheresis, and rituximab, he continued to have episodes of weakness and numbness and new areas of T2 hyperintensity on imaging. Neuro-ophthalmologic examination revealed a subclinical optic neuropathy with predominant involvement of the papillomacular bundle. Genetic evaluation and brain biopsy led to an unexpected diagnosis.

Original languageEnglish
Article numbere200194
JournalNeurology: Neuroimmunology and NeuroInflammation
Volume11
Issue number2
DOIs
StatePublished - Mar 2024
Externally publishedYes

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