Visual function before and after ACTH therapy for vision loss in multiple sclerosis

摘要

The visual function of a patient with multiple sclerosis (MS) was evaluated by visually evoked cortical potentials (VEPs) and the contrast sensitivity function (CSF) before and after adrenal corticotrophic hormone (ACTH) therapy for an acute exacerbation of the condition. Although Snellen visual acuity returned to normal in each eye, steady‐state pattern reversal VEP waveforms remained degraded long after therapy and monocular CSFs were reduced unequally 18 days after therapy, and even three years later. On the other hand, flash VEPs, recorded within three weeks of ACTH therapy, showed an improvement that parallelled the patient's overall improvement which appeared to be associated with the ACTH therapy. These observations indicate that MS can affect spatial and temporal channels differentially, reinforce the previously reported clinical utility of VEPs for the diagnosis of MS, and suggest that they may be simple, clinically useful, objective indices of the effectiveness of any interventive medical management of the diseas