[Devic's neuromyelitis optica: diagnosis after 10 years of bilateral severe relapsing optic neuritis]. / Neuromyélite optique de Devic: discussion diagnostique après dix ans d'évolution d'une neuropathie optique bilatérale sévère.

INTRODUCTION: Neuromyelitis optica, also known as Devic's disease, is a severe idiopathic inflammatory demyelinating disease of the central nervous system that preferentially affects the optic nerve and spinal cord. Neuromyelitis optica has long been thought of as a variant of multiple sclerosis; however, clinical, laboratory, immunological, and pathological characteristics that distinguish it from multiple sclerosis have now been recognized. CASE REPORT: A young man presented isolated severe bilateral relapsing optic neuritis. After having evolved over 10 years, the appearance of multiple sclerosis-like lesions on the brain led to the diagnosis of multiple sclerosis. Acute myelitis and the presence of NMO-IgG antibodies in the serum finally led to the diagnosis of neuromyelitis optica. CONCLUSION: This case is an illustration of the new criteria in the diagnosis of NMO, underscoring the importance of the positive serum NMO-Ig G antibody to distinguish multiple sclerosis from NMO. It also emphasizes that asymptomatic brain lesions are common in NMO on brain MRIs and symptomatic brain lesions do not exclude its diagnosis.

[Multifocal ERG using ERG-jet and Gold Foil electrodes in normal subjects: comparison and reproducibility]. / ERG multifocal avec électrodes ERG-jet et Gold Foil chez le sujet normal: comparaison et reproductibilité.

PURPOSE: To compare multifocal electroretinogram (mfERG) amplitudes with the Gold Foil electrode and ERG-jet electrode. To study mfERG amplitude changes between two successive records (intraindividual reproducibility). METHODS: The right eye of 27 normal subjects was examined. Two mfERG recordings using the 61-hexagon strategy (Vision Monitor, Métrovision, France) were made with both ERG-jet and Gold Foil electrodes. N1 and P1 wave amplitudes were analyzed in the central response and in four concentric rings. Bland and Altman analysis was used for the reproducibility study. RESULTS: MfERG amplitudes were significantly lower with the Gold Foil electrode, which averaged 72+/-10% of ERG-jet amplitudes. For N1 and P1 waves, the percentage change for the intraindividual reproducibility study was 9.1% and 6.7%, respectively, with the ERG-jet electrode and 18.2% and 13.5%, respectively, with the Gold Foil electrode. CONCLUSION: MfERG amplitudes were larger and more reproducible with an ERG-jet electrode than with a Gold Foil electrode. The limits of agreement of each ring can be used in clinical practice to determine whether the variation between two mfERG recordings over time is normal, which could reflect a retinal disorder.