A 13-year-old girl presented with new onset blurry vision in the left eye associated with painful eye movements. Three weeks earlier, weakness and paresthesias had developed in her left leg that spontaneously resolved. When a light was swung from the normal right eye (Panel A) to the affected left eye, the left pupil dilated (Panel B) – a finding known as a relative afferent pupillary defect. Fundoscopic examination of both eyes was normal. Examination of the brain and whole spine by means of magnetic resonance imaging showed multiple, oblong hyperintense lesions on T2-weighted images. What is the most likely etiology?
A. Acute disseminated encephalomyelitis
B. Leber hereditary optic neuropathy
C. Mononeuritis multiplex
D. Multiple sclerosis
E. Retinal detachment
答案解析：
正确答案是多发性硬化症。水通道蛋白 4 和髓鞘少突胶质细胞糖蛋白抗体的血清检测均为阴性。脑脊液中存在寡克隆带。开始使用类固醇后症状得到缓解，随后使用干扰素 beta-1a 进行维持治疗。
正确答案：D
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