Dr. Mobashir Sarfraz Ali, A17100 Dr. Nazia Imam, Dr. Rakhi Kusumesh
A 14 years male presented with progressive DOV of OU (LE for 10 days and RE from morning of presenting day) and pain on movement of LE with history of paraplegia (transverse myelitis) one year back. O/E vision of RE was 6/24 and of LE was PL+ with accurate PR, RAPD in LE, abnormal colour vision and mild blurring of disc margin OU.
MRI brain showed features of b/l acute optic neuritis (L>R) and previous MRI dorsal spine showed features of transverse myelitis and CSF analysis showed increase in protein, decrease in sugar and increase in lymphocytes, VEP showed prolonged latency in RE and absent response in LE and NMO IgG was negative. Thus fulfilling two absolute and two supportive criteria of neuromyelitis optica.
Trial of pulse steroid was given and patient gained vision of 6/6 in RE and 6/18 in LE after three days of pulse steroid and vision improve to 6/6 OU and during one month and on three month patient maintained vision of 6/6 OU without any ocular or systemic symptoms