OPTIC NEURITIS AFTER AGE 50 AS LINE PRESE NTING SIGN OF MULTIPLE-SCLEROSIS

Background The onset of multiple sclerosis after the at: of 50 fears i s rare. We report four patients with optic neuritis and oligoclonal ba nds or increased IgG production in the cerebrospinal fluid. Three of t hem subsequently developed clinically definite multiple sclerosis. Pat ients Four apparently healthy women, 62, 55, 50 and 50 years of age, p resented with progressive visual loss, three patients in one eye and o ne patient in both eyes. The diagnostic work-up revealed no findings i ndicating an ischemic process, an infectious, systemic inflammatory, o r neoplastic disease. Examination of the cerebrospinal fluid revealed oligoclonal bands and/or increased production of IgG. Visual acuity re covered during the following weeks to 8 months. Three of the 4 patient s subsequently developed additional neurology, signs compatible with m ultiple sclerosis. Conclusion Optic neuritis can be the presenting sig n of multiple sclerosis even after the ape of 50.