A case of recurrent optic neuritis with transverse myelitis in a young boy

Recurrent optic neuritis is associated with demyelinating disorders like multiple sclerosis or with transverse myelitis (neuromyelitis optica) and it is important to differentiate between the two as the treatment and prognosis differ. A 13 year old boy with with recurrent bilateral optic neuritis was treated with intravenous methyl prednisolone followed by oral prednisolone for the first 2 episodes. He developed optic neuritis with transverse myelitis 3 months after the first episode. His MRI brain was normal. MRI spine was abnormal for more than 3 segments. He was treated with azathioprine and his vision improved. This case stresses the importance of the correct diagnosis and appropriate management of bilateral recurrent optic neuritis.