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Visual loss with chronic meningeal and systemic inflammation
  1. Peter M Fernandes1,
  2. Lucy Kinton2,
  3. Stephen Madill3,
  4. Frederick R Burgess3,
  5. Euan McRorie4,
  6. Neeraj Dhaun1,
  7. Desmond Kidd5,
  8. Helen J Lachmann6,
  9. Richard J Davenport7,
  10. David Hunt1
  1. 1 College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
  2. 2 Department of Neurology, University Hospital Southampton NHS Trust, Southampton, UK
  3. 3 Department of Ophthalmology, NHS Lothian, Edinburgh, UK
  4. 4 Department of Rheumatology, NHS Lothian, Edinburgh, UK
  5. 5 Institute of Immunology and Transplantation, University College London, London, UK
  6. 6 National Amyloidosis Centre, University College London, London, UK
  7. 7 Department of Clinical Neurosciences, NHS Lothian, Edinburgh, UK
  1. Correspondence to Dr Peter M Fernandes, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh EH8 9YL, UK; peter.fernandes{at}


A 46-year-old man presented with worsening vision in the context of long-standing optic disc changes, bilateral sensorineural hearing loss, chronic aseptic meningitis, rash, arthralgia and raised inflammatory markers. The differential diagnoses of neoplasia, infection and inflammation are discussed. We highlight a condition that can present to adult neurologists, with successful diagnosis leading to targeted treatments that transform patient outcomes. This case was presented at the Association of British Neurologists Annual Meeting 2020 as a Clinicopathological Conference (CPC).

  • vision
  • neurogenetics
  • neuroimmunology
  • neuro-ophthalmology
  • vasculitis

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  • Contributors All authors fulfil ICJME criteria for authorship. All authors were involved in conception and design of the study, and acquisition and analysis of data, and have reviewed the manuscript. PMF drafted the manuscript and figures.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed by Neil Scolding, Bristol, UK.

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