| Identifier |
walsh_2020_s3_c2-pdf |
| Title |
Smoke Gets in Your Eyes (PDF) |
| Creator |
Tatiana Bakaeva, John Gittinger, Jr. |
| Subject |
Optic Neuropathy, Disc Edema, Paraneoplastic Syndromes |
| History |
A 61-year-old woman, active smoker with history of COPD, presented with bilateral progressive vision loss and ataxia. Four months prior to her presentation she developed 'black spot' in her right eye (OD) and was found to have 'OD disc edema and right hypertropia' by an outside ophthalmologist. She was admitted to the hospital where she had a brain MRI that was interpreted as normal. Lumbar puncture showed elevated CSF white cells and protein. CSF cultures were negative. She was diagnosed with viral meningitis and treated supportively with subjective improvement of vision. Over the next three months she developed progressive bilateral vision loss and severe ataxia to the point that she was not able to ambulate without a walker. On presentation to our neuro-ophthalmology clinic, her best corrected visual acuities were 20/60-2 OD and 3/200 OS, she missed 6.5 Richmond color plates OD and was unable to see the control plate OS. She had a left relative afferent pupillary defect. Her extraocular motility was full, and she had downbeat nystagmus. The external and anterior segment exams were normal. On funduscopic exam, she had bilateral moderate optic disc edema. Automated perimetry showed an inferonasal defect OD and generalized depression OS. The rest of her neurological exam was notable for dysmetria with left heel-to-shin probe and severe swaying in all directions when standing. She was unable to take any steps due to imbalance. |
| Disease/Diagnosis |
CRMP-5 paraneoplastic syndrome with bilateral optic neuropathy and cerebellar syndrome |
| Date |
2020-03 |
| References |
1. Antoine JC et al. J Neurol Sci: Jul 1993, Vol. 117(1-2): 215-23. 2. Cross SA et al. Ann Neurol. 2003 Jul; 54(1): 38-50 |
| Language |
eng |
| Format |
application/pdf |
| Type |
Text |
| Source |
2020 North American Neuro-Ophthalmology Society Annual Meeting |
| Relation is Part of |
NANOS Annual Meeting 2020: Frank B. Walsh Session 3 |
| Collection |
Neuro-Ophthalmology Virtual Education Library - Walsh Session Annual Meeting Archives https://novel.utah.edu/Walsh/index3.html |
| Publisher |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5945 |
| Rights Management |
Copyright 2020. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s64n4c5m |
| Setname |
ehsl_novel_fbw |
| ID |
1534165 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s64n4c5m |
