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Bilateral optic atrophy
Journal of Clinical Neuroscience 19 (2012) 434
Contents lists available at ScienceDirect
Journal of Clinical Neuroscience journal homepage: www.elsevier.com/locate/jocn
Images in Neuroscience: Question
Bilateral optic atrophy Sanjeev Jha ⇑, M.K. Ansari Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226 014, Uttar Pradesh, India
1. Clinical background A 34-year-old man presented initially with gastrointestinal symptoms and later developed neurological symptoms and signs (peripheral neuropathy and delirium) and alopecia. He was a strict vegetarian and took alcohol in moderation (50–100 mL per week). A photograph of his fundus is shown (Fig. 1). He later developed diminution of vision with visual field constriction and defective colour vision (Fig. 2). 2. What is the most likely diagnosis? A. B. C. D.
Vitamin B12 deficiency Thallium toxicity Arsenic toxicity Methanol poisoning.
Answer on page 488.
Fig. 2. Visual evoked response showing increased latencies in both eyes (upper panel, right eye; lower panel, left eye).
Fig. 1. Photograph of the fundus showing distinct signs of atrophy together with a deep temporal excavation (arrows). (This figure is available in colour at www.sciencedirect.com.)
⇑ Corresponding author. Tel.: +91 522 2494175; fax: +91 522 2668017. E-mail addresses: [email protected], [email protected] (S. Jha). 0967-5868/$ - see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.jocn.2010.12.036
Contents lists available at ScienceDirect
Journal of Clinical Neuroscience journal homepage: www.elsevier.com/locate/jocn
Images in Neuroscience: Question
Bilateral optic atrophy Sanjeev Jha ⇑, M.K. Ansari Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226 014, Uttar Pradesh, India
1. Clinical background A 34-year-old man presented initially with gastrointestinal symptoms and later developed neurological symptoms and signs (peripheral neuropathy and delirium) and alopecia. He was a strict vegetarian and took alcohol in moderation (50–100 mL per week). A photograph of his fundus is shown (Fig. 1). He later developed diminution of vision with visual field constriction and defective colour vision (Fig. 2). 2. What is the most likely diagnosis? A. B. C. D.
Vitamin B12 deficiency Thallium toxicity Arsenic toxicity Methanol poisoning.
Answer on page 488.
Fig. 2. Visual evoked response showing increased latencies in both eyes (upper panel, right eye; lower panel, left eye).
Fig. 1. Photograph of the fundus showing distinct signs of atrophy together with a deep temporal excavation (arrows). (This figure is available in colour at www.sciencedirect.com.)
⇑ Corresponding author. Tel.: +91 522 2494175; fax: +91 522 2668017. E-mail addresses: [email protected], [email protected] (S. Jha). 0967-5868/$ - see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.jocn.2010.12.036