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Multicentric malignant glioma of adulthood masquerading as optic neuritis

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From questions on page 782

  1. What clinical symptoms and signs of this case mimicked demyelinating optic neuritis? The subacute onset of vision loss in one eye associated with pain on eye movement was in keeping with a diagnosis of optic neuritis. Optic neuritis can occur in healthy men of his age, although female gender and the age range 15 to 45 are more typical. His exam findings of 20/400 vision, central scotoma, RAPD and mild disc oedema were also consistent with this diagnosis. The MRI findings of optic nerve enhancement and enlargement from mid-orbit extending into chiasm have also been described in optic neuritis.4 The additional brain lesions of corpus callosum and cerebellum pointed us towards multiple sclerosis and sarcoidosis as systemic causes of …

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