A Case of Opsoclonus-Myoclonus-Ataxia With Neuronal Intermediate Filament IgG Detected in Cerebrospinal Fluid
Abstract:
A 62-year-old man presented with headache, fever, and malaise. He was diagnosed with Anaplasma phagocytophilum, confirmed by serum polymerase chain reaction, and started on oral doxycycline. After 5 days of treatment, the patient began to experience gait imbalance with frequent falls, as well as myoclonus, and confusion. Examination was notable for opsoclonus-myoclonus-ataxia (OMA) and hypometric saccades. Cerebrospinal fluid (CSF) autoimmune encephalitis panel demonstrated a markedly elevated neuronal intermediate filament (NIF) immunoglobulin G antibody titer of 1:16, with positive neurofilament light- and ...
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Clinical-Pathological Case Study Source Type: research
Optic Perineuritis Associated With Cryptococcal Meningitis Presenting With a “Hot Orbit” in a Patient With Chronic Lymphocytic Leukemia
Abstract:
A 75-year-old man presented with 3 days of progressive left retro-orbital pain, eyelid swelling, tearing, and pain with extraocular movement. His medical history was significant for type II diabetes mellitus and chronic lymphocytic leukemia, stable on no therapy since diagnosis 8 years prior. The initial examination was significant for diffuse restriction of left ocular motility, marked lid edema, and mild dyschromatopsia. Computed tomography demonstrated asymmetric left periorbital soft tissue swelling and intraconal fat stranding with an irregular left optic nerve sheath complex and clear paranasal sinuses....
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Clinical-Pathological Case Study Source Type: research
Does Vitreopapillary Traction Cause Nonarteritic Anterior Ischemic Optic Neuropathy?
No abstract available (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Point Counter-Point Source Type: research
Prognostic Value of the Neurological Pupil Index in Patients With Acute Subarachnoid Hemorrhage
Background:
The Neurological Pupil index (NPi) provides a quantitative assessment of pupil reactivity and may have prognostic value in patients with subarachnoid hemorrhage (SAH). We aimed to explore associations between the NPi and clinical outcomes in patients with SAH.
Methods:
A retrospective analysis of 79 consecutive patients with acute SAH. Age, sex, Acute Physiology and Chronic Health Evaluation-II score, and respiratory failure and NPi in each eye were recorded at admission. The primary outcomes included death and poor clinical outcome (defined as inpatient death, care withdrawal, or discharge Glasgow O...
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Postinfectious SARS-CoV-2 Opsoclonus-Myoclonus-Ataxia Syndrome
Conclusion:
A recent simulation model of macrosaccadic oscillations and OMAS proposes a combined pathology of brainstem and cerebellar because of increased GABAA receptor sensitivity. In this case report, we report 1 patient with elevated CSF neuronal specific enolase, macrosaccadic oscillations, ocular flutter, and OMAS as a SARS-CoV-2 postinfectious complication. Opsoclonus emerged predominantly with fixation block and suppressed with fixation, providing support to modern theories on the mechanism responsible for these ocular oscillations involving cerebellar-brainstem pathogenesis. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Clinical Correlation Between Vertical Gaze Palsy and Midbrain Volume in Progressive Supranuclear Palsy
Background:
Supranuclear vertical gaze palsies and slowed vertical saccades are characteristic clinic features of progressive supranuclear palsy (PSP). The “hummingbird sign,” reflective of midbrain atrophy, is a classic radiographic sign of PSP. Correlation between eye movement abnormalities and radiographic findings in PSP has been reported previously. However, due to the use of clinical criteria not commonly employed in neuro-ophthalmic practice and neuroimaging techniques that are not widely available, it remains unclear whether correlation between midbrain structure and characteristic ocular-motor disturbances...
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Internuclear Ophthalmoplegia Characterizes Multiple Sclerosis Rather Than Neuromyelitis Optica Spectrum Disease
The objective of this work is to determine the comparative frequencies of INO in patients with NMOSD and MS and compare clinical features of both disease processes.
Methods:
This is a retrospective study of patients 18 years and older who have an established diagnosis of NMOSD or MS and were evaluated by both neuro-ophthalmology and neuro-immunology specialists between 2014 and 2020. Electronic medical records were screened for documentation of an acute INO at any time during follow-up. Incidence rates were calculated from number of cases of new-onset INO and patient years observed. Logistic regression was used to e...
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Clinical Characteristics for Predicting Recovery of Acquired Fourth Cranial Nerve Palsy
Conclusion:
Identifying whether a patient has an intracranial mass, severe oculomotor limitation, or large fundus excyclotorsion may be useful for predicting the recovery of acquired unilateral fourth cranial nerve palsy. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Interobserver and Intra-Observer Reliability of Eyelid Tests for Ocular Myasthenia Gravis
Conclusions:
CLT is the most reliable test among the 3 eyelid tests. However, all tests should be interpreted with caution by general ophthalmologists. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Invasive Fungal Sinusitis in Patients With Coronavirus Disease 2019 Seen in South India
Conclusion:
Our study emphasizes the need to screen for fungal involvement in COVID-19 cases presenting with MCNP especially on diabetic patients on systemic steroids so that an early diagnosis may reduce visual loss and mortality. Physicians treating COVID-19 cases need to be aware of this dreadful complication. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Use of Retinal Angiography and MRI in the Diagnosis of Giant Cell Arteritis With Early Ophthalmic Manifestations
Conclusion:
Our study shows that RA can be supplemented by MRI in a specialized center to provide the most accurate diagnosis in GCA revealed by visual signs. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
The Clinical Significance of Small Vessel Vasculitis on Temporal Artery Biopsies
Conclusions:
Patients with SVV on TAB had similar clinical features, PET/CT findings, and 6-month outcomes to those with negative biopsies. Small vessel vasculitis can be treated as equivalent to a negative biopsy when being considered for diagnosis and treatment of GCA. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Effect of Temporal Artery Biopsy Length and Laterality on Diagnostic Yield
Conclusions:
There is no significant association between greater length of biopsy and a positive TAB result in our data. Although the rate of positive results was not higher in the bilateral group compared with the unilateral group, 2.7% of bilateral biopsies were discordant, similar to previously published rates. Overall, this suggests that initial bilateral biopsy may increase diagnostic yield, albeit by a small amount. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Prognosticators of Visual Acuity After Indirect Traumatic Optic Neuropathy
Conclusions:
After evaluating multiple factors, initial VA was the only factor associated with visual prognosis in iTON. This knowledge may better enable clinicians to predict visual prognosis and set reasonable expectations with patients and families at the time of injury. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
Optic Nerve Abnormalities in Morning Glory Disc Anomaly: An MRI Study
Conclusion:
In patients with MGDA, optic nerve and chiasm abnormalities are the rule, with most often a unique pattern of irregular optic nerve thickness—hypertrophy and hypoplasia—from the orbit to the chiasm. Such pattern should be recognized and points to a developmental abnormality, rather than an optic nerve glioma. (Source: Journal of Neuro-Ophthalmology)
Source: Journal of Neuro-Ophthalmology - May 27, 2022 Category: Opthalmology Tags: Original Contribution Source Type: research
