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December 1980

Demyelinative Chiasmal Lesions

Author Affiliations

From the Emory University School of Medicine, Department of Neurology, Emory University, Atlanta (Dr Spector); the Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami (Dr Glaser); and the Neuroophthalmology Service, Wills Eye Hospital, Philadelphia (Dr Schatz).

Arch Neurol. 1980;37(12):757-762. doi:10.1001/archneur.1980.00500610037005

• To clarify the clinical syndrome of demyelinative chiasmal involvement, six case histories were analyzed and the literature was reviewed. This entity is characterized by especial predilection for women in the third to fifth decades; visual deficits of a chiasmal pattern that may be modest to marked, with a generally good prognosis for functional recovery; and other signs and symptoms, not necessarily severe, of scattered lesions of the neuraxis. Neuroradiological studies, especially laminography of the sellar area and computerized tomography, must be employed to rule out a suprasellar mass lesion. The efficacy of systemic corticosteroid therapy is moot, but it seems reasonable to use such agents during acute stages, especially where vision is severely reduced on both sides.