Management of acute optic neuritis

Patients with multiple sclerosis prefer early diagnosis

The new diagnostic criteria for multiple sclerosis (MS) allow for a definite diagnosis in earlier stages of the disease. Yet, clinicians may hesitate to pursue a diagnosis of multiple sclerosis at the presentation of first symptoms because they consider an early diagnosis of limited benefit to patients. It is unknown whether patients themselves prefer to be informed in an early phase. We studied satisfaction with the timing of diagnosis in patients recently diagnosed with MS and found that 75% was satisfied, 24% favoured an earlier, and only 6% a later disclosure of the diagnosis. Patients who preferred an earlier diagnosis had a significantly longer interval between their first visit to the neurologist and the disclosure of diagnosis (P < 0.001). The probability that the patient was satisfied with the timing of diagnosis did not substantially decrease in the months following the first visit to the neurologist, leaving ample opportunity for a thorough evaluation of the early clinical course. We conclude that patients with MS prefer an early diagnosis.

Echovirus type 4 as a probable cause of meningitis associated with bilateral optic neuritis: a case report

A 30-year-old man developed bilateral optic neuritis 1 week after acute viral meningitis caused by echovirus type 4. He received a high-dose steroid treatment combined with intravenous gamma -globulin. His visual recovery was good, and there was no sign of a primary demyelinating disease.