Optic neuritis in childhood. A pediatric series, literature review and treatment approach

Introduction. In children, the most common form of optic neuritis usually occurs after an infectious disease with papilledema, usually bilateral and has a good prognosis. Conversion to multiple sclerosis is low. Aim. To present clinical and laboratory case of optic neuritis in pediatrics features. Patients and methods. Seventeen clinical cases of optic neuritis in children and young people aged 4-14 years, referred from 2000 to 2015 were analyzed. Results. The median age of the series was 11 years. They predominated the female patients and infectious history was uncommon; in five of 17 patients was bilateral engagement and four cases evolved with retrobulbar optic neuritis. Magnetic resonance imaging showed hyperintensity on T-2 in the optic nerves affected in five patients. The study of cerebrospinal fluid and oligoclonal bands was normal in all cases. Patients treated with intravenous methylprednisolone had good recovery. It was found subsequent evolution to multiple sclerosis only in three cases. Conclusions. In our series, the cases that evolved multiple sclerosis showed no clinical differences although they had a higher number of hyperintense lesions on magnetic resonance imaging. This fact, described in previous studies, supports our diagnostic and therapeutic scheme in an attempt to approach the optimal management of this disease.