Martinelli V, Bianchi Marzoli S
Department of Neuroscience, Scientific Institute H.S. Raffaele, University Vita-Salute, Milan, Italy.
Neurol Sci. 2001 Nov;22 Suppl 2:S55-9. doi: 10.1007/s100720100035.
Alternative causes of optic neuritis (ON), other than primary demyelination or non-demyelinating optic neuropathies which can mimic acute ON, should be rigorously considered if a patient with presumed ON does not follow the typical clinical course or has a normally appearing brain on magnetic resonance imaging. A thorough differential diagnosis includes viral and bacterial optic neuropathies, ischemic optic neuropathies, Devic's neuromyelitis optica, compressive or infiltrative optic neuropathies, Leber's hereditary optic neuropathy and toxic and deficiency optic neuropathies. All patients should undergo a complete neuroophthalmological examination to help exclude other diseases mimicking ON. Atypical clinical cases of optic neuropathy require further specific laboratory, neurophysiological and imaging tests to make a correct and early diagnosis.
如果疑似视神经炎（ON）的患者未遵循典型临床病程或磁共振成像显示脑部正常，除了可模仿急性视神经炎的原发性脱髓鞘或非脱髓鞘性视神经病变外，应严格考虑视神经炎的其他病因。全面的鉴别诊断包括病毒和细菌性视神经病变、缺血性视神经病变、视神经脊髓炎、压迫性或浸润性视神经病变、Leber遗传性视神经病变以及中毒性和营养缺乏性视神经病变。所有患者均应接受全面的神经眼科检查，以帮助排除其他模仿视神经炎的疾病。视神经病变的非典型临床病例需要进一步进行特定的实验室、神经生理学和影像学检查，以做出正确的早期诊断。
