Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
-
Case Reports
Lymphomatoid granulomatosis presenting as an isolated unilateral optic neuropathy. A clinicopathologic report.
A 41-year-old woman presented with a unilateral optic neuropathy that progressed to no light perception 7 weeks later. The patient was hospitalized for progressive dyspnea; respiratory failure ensued and the patient died 10 days after admission. Antemortem pulmonary biopsies and the results of necropsy revealed lymphomatoid granulomatosis with extensive involvement of the lungs and left optic nerve. This is the first case report of lymphomatoid granulomatosis presenting as a unilateral optic neuropathy.
-
Two patients with biopsy-proven giant cell arteritis experienced bilateral transient vision loss after bending over and after getting up from a supine position. One patient had no demonstrable signs of carotid, ophthalmic, or anterior ciliary vascular disease, suggesting that his episodes of transient vision loss were due to vertebrobasilar insufficiency. ⋯ Bilateral transient postural vision loss is an uncommon manifestation of giant cell arteritis that could reflect either severe bilateral vascular compromise of the anterior circulation or severe vertebrobasilar insufficiency. In either situation, prompt evaluation and treatment is indicated to prevent the irreversible sequelae of the disease.
-
The objective of this article was to evaluate the etiologies, findings, and treatment of ocular neuromyotonia (ONM) in three case reports. The etiologies of ONM were determined by the histories, neuroradiologic tests, or biopsies. Clinical observations, videotaping, and electronic eye movement recordings documented the eye movement abnormalities. ⋯ Increasing the dose abolished the ONM. ONM is an unusual cause of intermittent diplopia and strabismus, but its distinctive history and signs identify it easily. Damage to the peripheral cranial nerves might produce segmental demyelination, axonal hyperexcitability, and a self-perpetuating, reverberating circuit that causes spasms of the extraocular muscles.
-
This article describes the effects of topically applied capsaicin (a nociceptive substance-P suppressor) in patients with neuropathic periocular or facial pain. Peripheral neuropathic pain is a major cause of periocular or facial discomfort and usually follows injury to a subcutaneous peripheral nerve. ⋯ We studied three patients who complained of a 2- to 30-year history of fluctuating pain in the periocular area. All three had an area of point tenderness that responded to the topical application of capsaicin cream.
-
Comparative Study
Frequency-selective fat suppression MR imaging. Localized asymmetric failure of fat suppression mimicking orbital disease.
Our objectives were to further characterize an artifact related to the localized failure of the frequency-selective (FATSAT) fat suppression magnetic resonance (MR) imaging technique. We constructed two phantoms simulating human orbital anatomy and imaged them on a 1.5-T MR scanner using (FATSAT) and short T1 inversion recovery (STIR) techniques of fat suppression. The first phantom resembled orbit structural configurations; it was imaged in coronal and axial planes and in varying orientations with respect to the main magnetic field (Z axis) to study the features of the artifact and to reproduce the asymmetry seen in clinical cases. ⋯ We concluded that failure of FATSAT fat suppression may mimic orbital disease, particularly if asymmetric. As predicted by the Maxwell electromagnetism equation, slight variations in orientation of the fat-air interface to the Z axis may produce large asymmetries in fat suppression failure in the orbit. Confirmation may require either comparison with additional pulse sequences [T1-weighted spin echo (T1W SE) or STIR] or repositioning the patient's head to check for persistence of the finding with varying orientations.