Exercise and the Optic Neuropathy of Multiple Sclerosis

Abstract

In most instances of optic neuropathy associated with multiple sclerosis it is difficult to ascribe the onset of visual symptoms to a particular precipitating factor. However, some patients with multiple sclerosis have an optic neuropathy that is initially provoked or temporarily aggravated by physical exertion (Uhthoff's symptom¹). It is the purpose of this paper to report four cases of multiple sclerosis with optic neuropathy in which episodes of visual impairment occurred during periods of exercise. Report of Cases Case 1. —A 25-year-old female was admitted to the Massachusetts General Hospital for evaluation of recurrent episodes of visual impairment that had started four years previously. Initially she had experienced numbness of her right lower extremity which lasted for four weeks. Shortly thereafter the vision in her left eye became limited to identification of large objects but returned to normal in about a month. Immediately after the birth of her child,