Leber’s Hereditary Optic Neuropathy with Oligoclonal Bandsin the Serum Regarded as Multiple Sclerosis – a Case Report

Česká verzia

Authors: L. Čechová ¹; A. Bartoš ^1,2; J. Bartošová ³; D. Doležil ¹
Authors place of work: Univerzita Karlova 3. LF a FN Královské Vinohrady, Neurologická klinika, Praha, 2Psychiatrické centrum Praha, 3Univerzita Karlova 3. LF a FN Královské Vinohrady, Oftalmologická klinika, Praha ¹
Published in the journal: Cesk Slov Neurol N 2009; 72/105(2): 155-158
Category: Case Report

Summary

Visi on deteri orated in an 18- ye ar-old man witho ut peri ocular pain during one week in the left eye first and in the right eye two months later. Ne urological findings were otherwise normal. Magnetic resonance imaging (MRI) of the brain was normal and there were high signals within optic nerves and chi asma. Oligoclonal IgG bands were repe atedly detected in the cerebrospinal fluid. As a result, the disorder was considered to be multiple sclerosis. The visi on failed to improve during one- ye ar follow‑up and no other impairment appe ared. The results of a uxili ary investigati ons were not in agreement with the atypical clinical co urse of the dise ase and normal MRI of the brain. We considered other di agnoses due to this discrepancy. Anti‑aqu aporin antibodi es did not support ne uromyelitis optica (Devic dise ase). Finally, the mitochondri al DNA mutati on confirmed Leber hereditary optic ne uropathy (LHON). The correct di agnosis was achi eved after bro ad interdisciplinary co operati on including foreign laboratory. This case illustrates the misle ading role of oligoclonal bands in cerebrospinal fluid and sho uld incre ase general knowledge about LHON in physici ans.

Key words:
multiple sclerosis – Leber hereditary optic ne uropathy – oligoclonal IgG bands – cerebrospinal fluid

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