ISSN:1070-8022    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Two unrelated adults with Ehlers-Danlos syndrome type IV developed acute unilateral ophthalmoplegia and ipsilateral headache as a consequence of spontaneous (nontraumatic) direct carotid-cavernous fistulas. Because the interventional radiologist suspected the diagnosis of Ehlers-Danlos syndrome type IV, the carotid-cavernous fistulas were closed via the venous rather than the more standard arterial route in an attempt to avoid arterial dissection or rupture. In any patient presenting with a spontaneous direct carotid-cavernous fistula, family history and clinical examination should be targeted toward a diagnosis of Ehlers-Danlos syndrome type IV because of risks attendant to angiography and repair of the fistula. For these patients, ancillary medical care must be approached cautiously to avoid hollow viscus rupture. Molecular tests can be used to confirm the diagnosis and provide family members with accurate genetic counseling and predictive genetic testing.

ISSN:1070-8022    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Four Indian patients with occipital lesions of cysticercosis presented with visual hallucinations. Neuro-ophthalmic and systemic examinations were normal in all cases except for one patient who had a partial homonymous hemianopia. Electroencephalography was normal in all cases. Neuroimaging revealed ring-enhancing lesions in the occipital lobe typical of neurocysticercosis. In endemic regions like India, neurocysticercosis should be suspected in patients presenting with visual hallucinations, even when there are no other clinical findings.

ISSN:1070-8022    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Oscillopsia in patients who have brain stem disorders but not nystagmus is attributed to a failure of the vestibular-ocular reflex (VOR) to compensate for head movements. We report a patient who had marked head titubation and oscillopsia in aggressive multiple sclerosis but no nystagmus. Her severe head titubation precluded our ability to measure a VOR accurately. Because oscillopsia has also been described after rapid voluntary head oscillations in normal subjects, we queried whether the oscillopsia in our patient could be ascribed to the head movement alone. Six normal control subjects did not experience oscillopsia while shaking their heads at the same frequency as the patient's titubation. We conclude that the oscillopsia in our patient was probably the result of an impaired VOR or an alternative compensatory mechanism.

ISSN:1070-8022    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

A patient with chronic inflammatory demyelinating polyneuropathy (CIDP) presented with an isolated unilateral adduction deficit and ptosis. Investigations were negative until the onset of limb weakness and fatigue 2 years later. At that time, electroneuromyography, cerebrospinal fluid examination, and magnetic resonance imaging confirmed the diagnosis of CIDP. Thus, ophthalmic signs can precede extremity and bulbar signs with a long latency in CIDP.

ISSN:1070-8022    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

A 21-year-old man developed an ipsilateral fourth nerve palsy, contralateral hemianopia, and contralateral hemisensory deficit as manifestations of a proximal right posterior cerebral artery aneurysm. This unusual constellation of signs reflects the involvement of the structures that run in the ambient cistern. The fourth nerve palsy and homonymous hemianopia are attributed to compression by the aneurysm. The hemisensory loss is ascribed to compromise of thalamoperforate arteries emanating from a thrombosed portion of the aneurysm.

ISSN:1070-8022    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

A 14-month-old boy with alternating hemiplegia of childhood, an idiopathic disorder of early childhood causing episodic hemibody tonic spasms and hemiplegia, showed repetitive jerks of abduction of the ipsilateral eye during the spells. The mechanism of this ocular motor abnormality is unknown but may be unique to this disorder.

ISSN:1070-8022    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

A patient who had achieved marked improvement in vision and shrinkage of a prolactinoma following treatment with pergolide (0.1 mg/day) suffered a marked worsening of vision 7 months after continued treatment at the same dose. Brain magnetic resonance imaging (MRI) at the time of visual loss showed further shrinkage of the tumor and prolapse of the chiasm into the pituitary fossa. The dose of pergolide was cut in half (0.05 mg/day); 12 months later, vision had completely recovered. Brain MRI at the time of visual recovery showed no change in the position of the prolapsed chiasm. This is the 11th reported case of delayed visual loss following dopaminergic treatment of prolactinoma. Recovery of vision always occurs with reduction of the medication dosage. Many patients whose prolactinomas are treated in this fashion display chiasmal prolapse, and few suffer visual loss. Considering that visual recovery occurs without a visible change in the position of the chiasm, traction is an unlikely cause of delayed visual loss. Therefore, the termchiasmal traction syndrome, used to describe visual loss with prolapsed chiasm following surgical and radiation treatment of sellar tumors, should not be applied in this setting lest it prompt consideration of surgical chiasmapexy. The proper management is reduction of the dopaminergic agonist dosage.

ISSN:1070-8022    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Periodic alternating nystagmus is a rare central nervous system disorder in which the eyes undergo a horizontal jerk nystagmus that periodically reverses direction. A patient with a hypoplastic cerebellum and enlarged cisterna magna exhibited transient periodic alternating nystagmus following an attack of Ménière's disease. We hypothesize that in susceptible individuals with cerebellar disturbances, periodic alternating nystagmus may be transiently induced by vestibular stimuli.

ISSN:1070-8022    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

A patient displayed a pink mass on the right optic disc and normal visual function that was diagnosed as a capillary hemangioma. Seven months later, he developed typical features of nonarteritic anterior ischemic optic neuropathy (NAION) in that eye. Such a long latency between “preeruptive” and “eruptive” disc edema has not been well documented in NAION.

ISSN:1070-8022    

出版商:OVID    

年代:2002

数据来源: OVID