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Case Rep Neurol. 2014 May 21;6(2):171-5. doi: 10.1159/000362868. eCollection 2014 May.

Recurrence of Susac Syndrome following 23 Years of Remission.

Case reports in neurology

Amalia Feresiadou, Urban Eriksson, Hans-Christian Larsen, Raili Raininko, Ingela Nygren, Atle Melberg

Affiliations

  1. Neurology, Department of Neuroscience, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden.
  2. Ophthalmology Units, Department of Neuroscience, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden.
  3. Otolaryngology Unit, Department of Surgical Sciences, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden.
  4. Radiology Unit, Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden.

PMID: 24987361 PMCID: PMC4067733 DOI: 10.1159/000362868

Abstract

Susac syndrome is an autoimmune microangiopathy affecting the brain, retina and inner ear (cochlea and semicircular canals), leading to encephalopathy, branch retinal artery occlusions (BRAOs) and asymmetric neurosensory hearing loss, respectively. The natural history and long-term prognosis are variable as the disease has been shown to be monophasic and self-limiting, polycyclic or chronic continuous. We describe a 35-year-old woman who presented with a sudden hearing loss in the left ear in the 37th week of her second pregnancy. She subsequently developed BRAO in the right eye 2.5 months after having given birth. MRI findings included round lesions in the corpus callosum which are pathognomonic for Susac syndrome. Previous patient records documented encephalopathy, sudden deafness of the right ear and visual field defects in the left eye at the age of 12, followed by permanent hearing and visual defects. We expand on the variability in the course of Susac syndrome as recurrence may occur after as long as 23 years. Cases of monophasic self-limiting Susac syndrome may in fact turn polycyclic with an interval of more than 2 decades between the bouts of the disease. In these cases, suspecting the development of exacerbation early is important in order to start the treatment promptly.

Keywords: Branched retinal artery occlusion; Corpus callosum; Encephalopathy; Hearing loss; Recurrence; Retinal vasculopathy; Susac syndrome; Visual loss

References

  1. Neurology. 1994 Apr;44(4):591-3 - PubMed
  2. Medicine (Baltimore). 1998 Jan;77(1):12-40 - PubMed
  3. Am J Clin Pathol. 2011 Dec;136(6):903-12 - PubMed
  4. Mayo Clin Proc. 2001 Sep;76(9):958-60 - PubMed
  5. Neurology. 2003 Dec 23;61(12):1783-7 - PubMed
  6. J Neurol Sci. 2007 Jun 15;257(1-2):270-2 - PubMed
  7. Neurology. 1979 Mar;29(3):313-6 - PubMed
  8. Eur J Neurol. 2012 Jun;19(6):800-11 - PubMed
  9. J Neurol Sci. 2010 Oct 15;297(1-2):71-3 - PubMed
  10. Nat Rev Neurol. 2013 Jun;9(6):307-16 - PubMed
  11. Curr Treat Options Neurol. 2008 Jan;10(1):67-74 - PubMed
  12. J Neurol Sci. 2010 Dec 15;299(1-2):86-91 - PubMed
  13. J Neurol Sci. 2009 Oct 15;285(1-2):259-61 - PubMed
  14. Medicine (Baltimore). 2007 Mar;86(2):93-102 - PubMed

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