Optic Neuropathy

Optic neuropathy due to nutritional deficiency presents with slowly progressive visual impairment, ultimately leading to blindness. Myelin and axonal degeneration of the optic nerves characterize the pathology (Fig. 10.13).

figure 10.12

Schematic drawing of distribution of myelin degeneration in Marchiafava-Bignami disease.

figure 10.12

Schematic drawing of distribution of myelin degeneration in Marchiafava-Bignami disease.

figure 10.13

Optic nerve degeneration. The disease of a 48-year-old shipping clerk, a heavy drinker, began with progressively failing vision that, over several weeks, progressed to the point that he was unable to read the shipping labels. He developed Wernicke encepha-lopathy and died several months later. A and B. Both optic nerves show partial myelin degeneration (myelin stain).

figure 10.13

Optic nerve degeneration. The disease of a 48-year-old shipping clerk, a heavy drinker, began with progressively failing vision that, over several weeks, progressed to the point that he was unable to read the shipping labels. He developed Wernicke encepha-lopathy and died several months later. A and B. Both optic nerves show partial myelin degeneration (myelin stain).

table 10.3.

Major Toxic Disorders of the Nervous System

Substances

Neuropathology

Carbon monoxide

Acute: congestion, edema, petechial hemorrhages

Chronic: bilateral pallidal necrosis, cortical necrosis, leukoencephalopathy

Cyanide

Edema, petechial hemorrhages

Necrosis: basal ganglia, hemispheric white matter,

Purkinje cell degeneration

Methanol (methyl alcohol)

Retinal ganglionic degeneration, optic nerve degeneration, Putaminal necrosis, hemorrhagic leukoencephalopathy

Lead

Encephalopathy: edema, congestion, petechial hemorrhages, capillary, endothelial hyperplasia, motor neuropathy

Arsenic

Peripheral neuropathy, predominantly axonal Hemorrhagic leukoencephalopathy (hypersensitivity reaction)

Manganese

Bilateral pallidal degeneration, Subthalamic n. degeneration

Mercury (organic and inorganic)

Cortical neuronal degeneration: calcarine and motor cortex, Granule cell degeneration in cerebellar cortex

Aluminum

Cortical gliosis

Hexacarbon (sniffing glue)

Giant axonal neuropathy

Methotrexate (intrathecal)

Meningitis, meningoencephalitis, transverse myelitis, Disseminated necrotizing coagulative leukoencephalopathy

Vincristine

Cranial neuropathy, peripheral axonal neuropathy, Myelopathy with eosinophilic intracytoplasmic inclusions

Phenytoin

Cerebellar cortical degeneration, Peripheral, predominantly sensory neuropathy

Peripheral Neuropathy Natural Treatment Options

Peripheral Neuropathy Natural Treatment Options

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