Optic neuritis after age 50 as line presenting sign of multiple sclerosis

Background The onset of multiple sclerosis after the at: of 50 fears is rare. We report four patients with optic neuritis and oligoclonal bands or increased IgG production in the cerebrospinal fluid. Three of them subsequently developed clinically definite multiple sclerosis. Patients Four apparently healthy women, 62, 55, 50 and 50 years of age, presented with progressive visual loss, three patients in one eye and one patient in both eyes. The diagnostic work-up revealed no findings indicating an ischemic process, an infectious, systemic inflammatory, or neoplastic disease. Examination of the cerebrospinal fluid revealed oligoclonal bands and/or increased production of IgG. Visual acuity recovered during the following weeks to 8 months. Three of the 4 patients subsequently developed additional neurology, signs compatible with multiple sclerosis. Conclusion Optic neuritis can be the presenting sign of multiple sclerosis even after the ape of 50.