Relapsing White Matter Disease and Subclinical Optic Neuropathy.
Kimberly A O'NeillAndrew DugueNicolas J AbreuLaura J BalcerMarc BrancheSteven L GalettaJennifer S GravesIlya KisterCynthia MagroClaire MillerScott D NewsomeJohn PappasJanet RuckerConnolly SteigerwaldChristopher M WilliamScott S ZamvilScott N GrossmanLauren B KruppPublished in: Neurology(R) neuroimmunology & neuroinflammation (2024)
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.
Keyphrases
- white matter
- multiple sclerosis
- contrast enhanced
- magnetic resonance imaging
- young adults
- high resolution
- mental health
- diffuse large b cell lymphoma
- genome wide
- computed tomography
- ultrasound guided
- combination therapy
- magnetic resonance
- copy number
- systemic lupus erythematosus
- mass spectrometry
- fluorescence imaging
- diffusion weighted imaging
- disease activity
- brain injury
- hodgkin lymphoma