Département de neurologie, hôpital Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
Rev Neurol (Paris). 2012 Oct;168(10):697-701. doi: 10.1016/j.neurol.2012.07.013. Epub 2012 Sep 12.
Inflammatory optic neuritis (ON) represents a frequent clinical situation in neurology and ophthalmology. The most current etiology is multiple sclerosis (MS) but, when MRI and Cerebrospinal fluid (CSF) analyses are normal, ON is usually considered as "idiopathic" with a suspected viral etiology. In rare cases, a systemic disease such as sarcoidosis, lupus or Sjögren syndrome may be diagnosed. In several cases either a recurrence or a myelitis may occur without any argument for MS. In the first case, it corresponds to relapsing inflammatory optic neuritis (RION) and in the second case to neuromyelitis optica (NMO). In the present paper, the author successively presents the various clinical situations and complementary findings (infectious, vasculitis, NMO or idiopathic) that can lead to a differential diagnosis of MS in a context of ON.
炎性视神经炎（ON）是神经科和眼科常见的临床情况。目前最常见的病因是多发性硬化症（MS），但当 MRI 和脑脊液（CSF）分析正常时，ON 通常被认为是“特发性”的，病因疑似病毒。在罕见情况下，可能会诊断出结节病、狼疮或干燥综合征等系统性疾病。在某些情况下，即使没有 MS 的依据，也可能会发生复发或脊髓炎。在第一种情况下，它对应于复发炎性视神经炎（RION），在第二种情况下，对应于视神经脊髓炎（NMO）。在本文中，作者依次介绍了各种临床情况和辅助检查结果（感染、血管炎、NMO 或特发性），这些结果可在 ON 背景下导致 MS 的鉴别诊断。
