AN EPIDEMIC OF OPTIC NEUROPATHY AND PAINFUL SENSORY NEUROPATHY IN CUBA - CLINICAL ASPECTS

An epidemic of bilateral optic neuropathy and painful sensory neuropat hy occurred in Cuba in 1991-1993. Over 45 000 individuals were stated to have been affected. We report a clinical study on 25 patients seen in Cuba in 1993-1994. Affected patients showed either bilateral optic neuropathy with caecocentral scotomata or a distal predominantly senso ry neuropathy sometimes associated with deafness, or a combination of both optic and peripheral sensory neuropathy. The nature of the epidem ic is discussed. The clinical features in patients with confirmed neur ological deficits were consistent with a diagnosis of Strachan's syndr ome, probably related to nutritional deficiency. Other patients with s imilar symptoms showed no evidence either of optic or peripheral neuro pathy and were considered to represent disease mimicry on a psychoneur otic basis.