Answer: You astutely note optic disc swelling in the left eye.
You order an MRI brain and orbits. A few of the images are shown below:
The radiology report reads:
“MRI Brain: Multiple non-enhancing foci of FLAIR hyperintensity, predominantly in the periventricular regions. Thickening and enhancement along the visualized course of the left optic nerve.”
What’s the most likely diagnosis? Pick 1 before scrolling down.
Demyelinating optic neuritis
Acute ischemic optic neuropathy
Amaurosis fugax
Retinal detachment
Idiopathic intracranial hypertension
Orbital meningioma
Migraine with aura
What underlying condition most likely led to this acute presentation? Pick 1 before moving on.
Sarcoidosis
Neurosyphilis
Meningitis
Multiple sclerosis
Polymyalgia rheumatica
Click here to move on!
Neuro-oph Case 3 Index
Neuro-oph Case 3: Introduction
Neuro-oph Case 3: Physical Exam