Skill Checkup: Suboptimally Treated Relapsing-Remitting Multiple Sclerosis (RRMS)

Christopher Luzzio, MD


September 24, 2021

The clinical and MRI findings in this case are consistent with a diagnosis of optic neuritis secondary to MS. The patient is treated with intravenous corticosteroids. Other treatment options for optic neuritis include oral corticosteroids and immunomodulatory therapy, such as plasmapheresis.

AION occurs in individuals ≥ 50 years of age; moreover, pain is present only in < 10% of patients. Therefore, AION is less probable in this case.

LHON primarily affects young men (up to 90% of cases). Therefore, this disease is an unlikely cause for this patient's symptoms.

Compressive toxic/nutritional optic neuropathy is characterized by a gradual onset of vision loss over months, as opposed to the acute onset that is seen with optic neuritis.


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