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2018 ; 13
(2
): 191-194
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A Case of Post Encephalitic Optic Neuritis: Clinical Spectrum, Differential
Diagnosis and Management
#MMPMID29719649
Kumar R
; Bhargava A
; Jaiswal G
; Soni VR
; Katbamna B
; Vashisht A
J Ophthalmic Vis Res
2018[Apr]; 13
(2
): 191-194
PMID29719649
show ga
PURPOSE: Most cases of optic neuritis are idiopathic or are associated with
multiple sclerosis. We present a case in which a young female developed
post-infectious left optic neuritis following herpes simplex encephalitis (HSE).
CASE REPORT: A 24-year-old female presented with a severe headache, fever, and
malaise of a one-week duration. Viral encephalitis was diagnosed and treated;
intravenous acyclovir (750 mg every 8 h) was administered for 14 days. The
patient improved clinically and was prescribed oral valacyclovir (1,000 mg, three
times daily) for an additional 3 months as an outpatient. The patient presented
again four weeks after the initial admission with left periocular pain and other
typical manifestations of optic neuritis. We diagnosed post-infectious left optic
neuritis following viral encephalitis. Corticosteroid therapy with 250 mg
intravenous methylprednisolone every 6 hours was initiated and the patient showed
rapid significant recovery. CONCLUSION: This case report highlights the patient's
clinical course and includes a brief history of the systemic effects of HSE, as
well as the pathophysiology, management, and differential diagnosis of
post-encephalitic optic neuritis. We suggest that clinicians should routinely
perform an ophthalmologic examination during the follow-up visits of such
patients.