Case Series: Diverse Causes of Vision Loss and Cranial Neuropathies in Young Females – A Diagnostic Challenge

Background: Vision loss and cranial nerve palsies in young individuals can have a broad differential diagnosis, ranging from infectious to autoimmune and inflammatory conditions. Recognizing patterns and timely investigations are crucial for appropriate management. Objective: To present a series of five cases with acute or subacute visual symptoms and cranial nerve involvement with varied etiologies including infectious, inflammatory, autoimmune, and idiopathic causes. Methods: Retrospective observational series of five young female patients presenting to a neurology department over 1 year with visual complaints and/or cranial nerve involvement. Clinical evaluation, neuroimaging, CSF analysis, and serological workup were done. Results: Etiologies included HHV6-associated cavernous sinus thrombosis, presumed tubercular pituitary hypophysitis, multiple sclerosis, Tolosa-Hunt syndrome, and neuroretinitis. All patients responded well to targeted therapy based on etiology. Conclusion: A systematic approach integrating neuroimaging a