Pearls & Oy-sters: Leber Hereditary Optic Neuropathy-Plus Masquerading as Neuromyelitis Optica Spectrum Disorder in a 2-Year-Old Child

Abstract

c"Leber hereditary optic neuropathy (LHON-Plus)" is a phenotype of LHON that is characterized by extraocular neurologic manifestations, which may be the first manifestations of the disease.c Extraocular manifestations of LHON-Plus can include movement disorders, peripheral neuropathy, seizures, and demyelinating-like syndromes.Oy-sters c LHON-Plus can be highly difficult to distinguish from acquired demyelinating diseases based on radiologic findings alone, although a predilection for the dorsal columns in the spinal cord has been noted in LHON-Plus. c In rare cases, the co-occurrence of aquaporin-4 (AQP4+) NMOSD and LHON has been reported.