Isolated optic neuritis in acute disseminated encephalomyelitis—A case report

AbstractAn 8-year-old boy presented with blurred vision in both eyes with intermittent pain over his brow area for 1–2 weeks. There was an episode of upper respiratory tract infection shortly after he had received H1N1 vaccination 1 month previously. Decreased visual acuity (especially in the right eye) with impaired color vision in both eyes was also noted. Results of his physical examination were all within normal limits except for a bilateral swollen disc. Brain magnetic resonance imaging revealed multiple hyperintense patches in the subcortical white matter of the bilateral frontal–parietal lobes. Methylprednisolone pulse therapy was prescribed then tapered with oral prednisolone for 6 months. Following magnetic resonance imaging performed 6 months after initial treatment, the previous lesions were no longer seen. A diagnosis of acute disseminated encephalomyelitis was confirmed. Visual acuity was recovered in the latest follow-up. Isolated optic neuritis is an uncommon feature of acute disseminated encephalomyelitis. It should be differentiated from multiple sclerosis, which will relapse, and permanent hyperintense lesions can be seen in the follow-up images