Circadian temperature rhythm and vision in multiple sclerosis

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Abstract
A patient with optic neuritis secondary to multiple sclerosis demonstrated daily changes in visual acuity. This visual fluctuation occurred in a rhythmical and predictable fashion. Evaluation revealed that the visual changes seemed to correlate best with the daily fluctuations of body temperature. Plasma electrolyte and cortisol levels and urinary excretion of 17-OHC [ 17-hydroxycorticosteroids] all showed normal rhythms without unusual levels. Intravenous infusion of hydrocortisone, oral administration of nicotinic acid, and exercise (short of causing body temperature to rise) did not appear to affect visual acuity. Only when exercised to the point of causing body temperature to rise did visual acuity deteriorate. Heating and cooling the patient caused marked changes in visual acuity as a result of these maneuvers.

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