How does pediatric optic neuritis in multiple sclerosis (MS) differ from the adult-onset syndrome?

Updated: Feb 21, 2019
  • Author: Fiona Costello, MD, FRCP; Chief Editor: Hampton Roy, Sr, MD  more...
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Several features of the clinical presentation and course differentiate pediatric optic neuritis from the adult-onset syndrome. While both children and adults present with vision loss, pain upon eye movements, dyschromatopsia, and visual field defects, children are more likely to present with more severe vision loss. [19] Children with optic neuritis more frequently demonstrate papillitis or anterior optic neuritis than their adult counterparts. [19] Moreover, younger pediatric patients are more likely than adolescents or adults to experience bilateral simultaneous optic nerve involvement.ref48} Although the presence of unilateral or bilateral optic nerve involvement does not predict the risk of MS in children, MS risk increases with age. [19]

Normal-appearing right optic nerve and mild left o Normal-appearing right optic nerve and mild left optic disc edema.

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