Transient bilateral blindness associated with presumptive idiopathic pachymeningitis in a 22-year-old Irish Sport Horse

Summary

A 22-year-old Irish Sport Horse presented following a period of bilateral blindness with subsequent spontaneous resolution. Brain magnetic resonance imaging (MRI) demonstrated features consistent with pachymeningitis. Cerebrospinal fluid (CSF) analysis revealed increased numbers of basophils, suggestive of an immunologic or neoplastic aetiology. It was suspected that the enlarged meninges led to compression of the optic nerves in the optic canals, causing bilateral blindness. Initial spontaneous remission, as seen in this case, has been reported in human patients with this condition. Pachymeningitis should be considered as a possible cause of cranial nerve deficits, including bilateral and unilateral blindness, in horses.