10 minute Amaurosis Fugax presenting in ED in MS

[Indryd]

Anyone ever seen this?

Test question today was lady comes into the ED c/o a 10 minute "curtain fell over my eye" vision loss one hour ago that now is completely resolved.

She gives a hx consistent with MS, but I assumed that was just a red herring. I know MS is "characterized by waxing and waning of symptoms," but 10 minutes?

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[future_dr_house]

So I had a pt with that exact story a couple days ago. But she had a hx of a retropharyngeal mass s/p radiation treatments mainly on the right side of her neck where it was. She had a bruit on exam and ct a of the neck showed a severe stenosis of the right ICA. She had been having fugax sx since January but never had full loss of vision until that day but when it happened she had painless vision loss for 10 min that fully resolved without localizing findings.

 

[Indryd]

OK, so maybe I wasn't clear about htis.

In the question, the explanation for the episode was that people with MS are prone to optic neuritis (duh), and that this episode was indeed a presentation of optic neuritis (as in no vascular stuff at all).

 

[future_dr_house]

Ah my bad I thought you were asking generally about a person with that presenting symptom and not just about MS.

 

[Rendar5]

I'm sure I will get corrected, but I'm sorry, I've never heard of a 10 minute-long painless optic neuritis.