A patient has had recurrent optic neuritis bilaterally with transverse myelitis. Visual acuity in right eye is 6/60 and left eye is 6/18. Patient showed a 50% response to steroids. Diagnosis is?
(A) Neuromyelitis Optica (B) Subacute combined degeneration of spinal cord(SACD) (C) Post cerebral aery stroke (D) Neuro-syphilis
(A) Combination of transverse myelitis and optic neuritis is diagnosis of Neuromyelitis optica. SACD:- has only spinal cord involvement. Babinski sign (+), Areflexia, Romberg sign Post cerebral aery stroke - Do not cause myelitis & response to steroids. Mid brain stroke: P1 segment involvement Coical blindness d/t inv. of occipital lobe (P2 segment) Neuro-syphilis - Responsive to Antibiotics rather than steroid Argyll Robeson pupil Lhermitte sign Sensory ataxia/tabes dorsalis Neuromyelitis Optica (Devic's Disease) Optic neuritis Transverse myelitis Area postrema syndrome Diencephalic syndrome Acute brainstem syndrome Cerebral syndrome (coical syndrome)