DISEASES OF THE OPTIC NERVE AS AN EARLY OR EARLIEST SYMPTOM OF MULTIPLE SCLEROSIS

The involvement of the optic nerves in multiple sclerosis is not an infrequent phenomenon. Charcot and Oppenheim consider it even frequent. Uhthoff observed it in at least half of the cases. Kampherstein found it in 70 per cent. Marx1found changes in the optic nerve six times in sixteen cases. Consequently changes in the heads of the optic nerves during the course of multiple sclerosis are a well-known occurrence. Far more important is the occurrence of optic nerve disturbances as an early symptom or as the earliest manifestation of multiple sclerosis. Their recognition is extremely important from a prognostic standpoint. A statistical study of the subject shows that changes of the optic nerve or nerves may precede the onset of other symptoms of insular sclerosis for a period of between ten years and six months. Oppenheim observed one case in which optic neuritis and subsequent atrophy was