Prognosis of optic neuritis with special reference to cerebrospinal fluid immunoglobuhs and measles virus antibodes

Abstract

Forty-eight patients with optic neuritis (ON), first seen in 1970 to 1973, were neurologically and neuroophthalmologically reexamined after 7 to 10 years. Twenty-seven patients (56%) had probable MS, and 9 (19%) had possible MS. During the attack of ON, the cerebrospinal fluid (CSF) samples and serum/CSF measles antibody ratios were studied. Twenty patients had increased relative immunoglobulin G (IgG) (% of total protein) in their CSF; 19 of these had probable or possible MS. However, 17 of 28 patients with a normal relative IgG value had also developed MS. CSF electrophoresis was abnormal in 20 patients with ON; reexamination showed that 19 had probable or possible MS. Sixteen of 27 patients with normal electrophoresis had also developed MS. Serum/CSF measles antibody ratio had decreased in 19 patients; 13 of these had probable MS and 3 had possible MS. Of 29 patients with a normal measles antibody ratio, 14 had probable MS and 6 had possible MS. The conclusion is that examination of the CSF in ON gives valuable prognostic information because increased relative IgG, abnormal electrophoresis, or a decreased measles antibody ratio implies a high risk of developing MS. A normal CSF does not, however, rule out the possibility of dissemination.

Evaluation of central nervous system involvement in uncomplicated optic neuritis after prolonged follow-up

“…It is noteworthy that the CSF showed an increase of relative gammaglobulin level only in one case. An elevated gammaglobulin was seen in 42% of patients with acute ON in a Finnish series (25). As presented in that study, a normal CSF seems to mean a better prognostic value in regard to the risk of developing MS.…”

“…An elevated gammaglobulin was seen in 42% of patients with acute ON in a Finnish series (25). An elevated gammaglobulin was seen in 42% of patients with acute ON in a Finnish series (25).…”

Optic Neuritis or Multiple Sclerosis

“…Moulin D, Paty DW, Ebers GC: The predictive value of CSF electrophoresis in 'possible' multiple sclerosis. 14. 12.…”

Intrathecal synthesis of virus-specific oligoclonal IgG, and of free kappa and free lambda oligoclonal bands in acute monosymptomatic optic neuritis. Comparison with brain MRI

“…30 A previous study using an ELISA technique showed that the serum/CSF antibody ratio range for measles, rubella and mumps in patients with AMON were intermediate to those obtained in patients with CDMS and in control patients. 31 Furthermore, a decreased serum/CSF antibody ratio at onset of AMON implied a high risk of developing MS. 32 In our study, ®ve of 27 patients developed additional symptoms and signs of demyelinating disease within one year of follow up. All these patients had oligoclonal IgG bands, virus-speci®c oligoclonal IgG antibodies against one or more speci®c viruses, and abnormal MRI at onset of AMON.…”