An epidemic of optic neuropathy and painful sensory neuropathy in Cuba: clinical aspects.

An epidemic of bilateral optic neuropathy and painful sensory neuropathy occurred in Cuba in 1991-1993. Over 45,000 individuals were stated to have been affected. We report a clinical study on 25 patients seen in Cuba in 1993-1994. Affected patients showed either bilateral optic neuropathy with caecocentral scotomata or a distal predominantly sensory neuropathy sometimes associated with deafness, or a combination of both optic and peripheral sensory neuropathy. The nature of the epidemic is discussed. The clinical features in patients with confirmed neurological deficits were consistent with a diagnosis of Strachan's syndrome, probably related to nutritional deficiency. Other patients with similar symptoms showed no evidence either of optic or peripheral neuropathy and were considered to represent disease mimicry on a psychoneurotic basis.