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AN AUTOPSY CASE OF DEMYELINATING OPTIC NEURITIS (A SUBTYPE OF NEUROMYELITIS OPTICA) Shoji IWASE 1 , Hiroshi KOBAYASHI 1 , Toshizo ITO 1 1Dept. of Nearopsychiatry, Nagoya Univ. School of Med. pp.691-696
Published Date 1967/7/1
DOI https://doi.org/10.11477/mf.1406202242
  • Abstract
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A 74 year-old female was admitted with acute visual disturbance. She was diagnosed retrobulbar neuritis on examination of impaired visual acuity and optic atrophy on ocular fundi. After half a year, her visual acuity became to be 0 at right and 0.02 at left. Twenty months later, she complained of spontaneous pain on scapula and upper portion of back, intense "shibire" feeling, particularly on left upper and lower limbs. Thereafter, she died soon in coma and Cheyne-Stokes' respiration.

Marked gross and histopathological changes were fo-und mainly in the optic nerve. Severe demyelination, necrosis, glio-mesenchymal scarring and many cystic ca-vitation were noticed throughout entire area from the optic nerve to the ocular fundi. In these lesions, ven-ous vessels walls were fibrohyalinously thickened and perivascular lymphocytic infiltration occured in slight to moderate degree. Further, neurons of corpus ge-niculatum laterale were secondarily degenerated and in calcarine cortex, some eosinophilic bodies of unknown origin were scattered adjacent to capillaries.

Some localized lesions similar to those of the optic nerve as mentioned above were found in the white matter adjacent to the lateral ventricle. Slight in-flammatory infiltration developed in the lept-meninges.

In the center of upper cervical cord to the caudal most medulla oblongata, an acute softenning focus de-veloped.

Histopathological diagnosis of this case is demye-linating optic neuritis. The above histopathological findings seems to correspond to those of neuromyelitis optica, Devic. Because of minor change of spinal cord, this case is an atypical neuromyelitis optica, but seems to fall into the subtype (optic type).

The possible relation between the clinical retrobulbar neuritis and neuromylitis optica in Japan was discussed.


Copyright © 1967, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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