Increased incidence of Susac syndrome: A case series study

A. Wilf-Yarkoni*, O. Elkayam, O. Aizenstein, Y. Oron, V. Furer, D. Zur, M. Goldstein, D. Barequet, H. Hallevi, A. Karni, Z. Habot-Wilner, K. Regev

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Susac syndrome (SuS) is a rare condition characterized by a clinical triad of sensorineural hearing loss, branch artery occlusion and encephalopathy. This study reports an increased incidence of SuS in Israel. We describe the clinical characteristics of these patients, diagnostic procedures and the use and subsequent outcomes of newly published treatment guidelines. Methods: This is a single center retrospective study. Patients who were diagnosed with SuS between July 2017 and August 2018 were enrolled in this study. Results: Seven patients were diagnosed with SuS according to the diagnostic criteria in a time period of 13 months. The annual incidence was recently evaluated in Austria to be 0.024/100000, therefore, our case series represent at least a 5.4-fold increase in the annual incidence of SuS expected in Israel and a 7-fold increase in the annual incidence expected in our medical center. Mean time from the onset of the symptoms to diagnosis was three weeks and follow-up time was twenty four months. Recent exposure to cytomegalovirus was serologically evident in three patients and one patient had high titer of anti-streptolysin antibody. All patients underwent brain MRI, fluorescein angiography and audiometry. All patients were treated according to the newly recommended guidelines. All patients achieved clinical and radiological stability. Conclusions: We report of an increased incidence of SuS in Israel. Infectious serological findings may imply a post infectious mechanism. The use of the recommended diagnostic procedures reduced the time to diagnosis. Newly published treatment guidelines led to favorable clinical outcomes.

Original languageEnglish
Article number332
JournalBMC Neurology
Volume20
Issue number1
DOIs
StatePublished - 2 Sep 2020

Keywords

  • Branch retinal artery occlusion
  • Susac syndrome
  • Treatment
  • cmv post infectious

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