Leber's Hereditary Optic Neuropathy with Oligoclonal Bands in the Serum Regarded as Multiple Sclerosis - a Case Report
Abstract
Vision deteriorated in an 18-year-old man without periocular pain during one week in the left eye first and in the right eye two months later. Neurological findings were otherwise normal.
Magnetic resonance imaging (MRI) of the brain was normal and there were high signals within optic nerves and chiasma. Oligoclonal IgG bands were repeatedly detected in the cerebrospinal fluid.
As a result, the disorder was considered to be multiple sclerosis. The vision failed to improve during one-year follow-up and no other impairment appeared.
The results of auxiliary investigations were not in agreement with the atypical clinical course of the disease and normal MRI of the brain. We considered other diagnoses due to this discrepancy.
Anti-aquaporin antibodies did not support neuromyelitis optica (Devic disease). Finally, the mitochondrial DNA mutation confirmed Leber hereditary optic neuropathy (LHON).
The correct diagnosis was achieved after broad interdisciplinary cooperation including foreign laboratory. This case illustrates the misleading role of oligoclonal bands in cerebrospinal fluid and should increase general knowledge about LHON in physicians