Childhood optic neuritis: The pediatric neurologist's perspective

Background: Optic neuritis in children may be an isolated, usually postinfectious event, or the symptom of a more widespread disorder. Aim: To investigate the etiological spectrum of optic neuritis in children in association with diagnostic findings and follow-up results. Methods: We retrospectively examined the records of 31 children aged 4-15 (mean 9.7 ± 2.9) years in whom isolated optic neuritis was the presenting neurological symptom. Results: Monophasic bilateral optic neuritis was the most common presentation (45%), followed by the unilateral (32%) and recurrent (22%) forms. Initial cranial MRI was abnormal in 12/31 patients. During a mean follow-up of 2.2 years (6 months-15 years), 6/14 bilateral cases, 9/10 unilateral and 5/7 recurrent cases were diagnosed with various disorders including total eight with MS. The MS group tended to start with unilateral optic neuritis, was older (mean 11.6 ± 1.5 vs. 8.8 ± 2.9 years), and included more girls than the other groups. Conclusions: Optic neuritis in children is frequently part of a systemic or neurological disorder even in the presence of normal cranial imaging. These patients should be evaluated and followed-up in pediatric neurology clinics.