A Case of Neuromyelitis Optica Presenting with Orbital Inlammation

Update Item Information
Identifier 20190317_nanos_posters_054
Title A Case of Neuromyelitis Optica Presenting with Orbital Inlammation
Creator Lucy A. Bailey; Esther Osuji; Roy Riascos; Ore-ofe Adesina
Affiliation (LAB) (EO) (RR) (OA) The University of Texas Health Science Center at Houston, Houston, TX
Subject Demeylinating Disease; Neuro-Ophth & Systyemic Disease ( eg. MS, MG, Thyroid)
Description A 45-year-old African-American man with no medical history experienced acute onset of eye pain OD associated with vision loss followed by double vision and subjective bulging OD following 2 months of intermittent eye soreness OD. He presented to the emergency department where visual acuity was counting fingers OD and 20/20 OS. The right pupil was minimally reactive with a relative afferent pupillary defect. He was found to have a partial, right, pupil-involving cranial nerve (CN) III palsy with normal motility OS. IOP was normal OU. Dilated fundus exam showed 360-degree optic disc edema and tortuous vessels OD and was normal OS. Magnetic resonance imaging (MRI) of the orbits with and without contrast showed increased T2 signal with tortuosity and thickening of the retrobulbar optic nerve OD from the globe to the optic canal with posterior globe flattening. There was associated restricted diffusion and enhancement of the optic nerve OD, with enhancement of the orbital fat adjacent to the optic nerve sheath with relative proptosis OD. Brain MRI showed no other lesions. Magnetic resonance angiography showed no vascular anomalies, and cervical spine MRI was unremarkable. RPR, ACE, ANCA, ANA, IgG4, RF, anti-CCP, SPEP, and MOG were negative. Neuromyelitis optica antibody was elevated at 15.3 unit/mL (normal <3.0). Cerebrospinal fluid analysis was normal. He received 5 days of intravenous solumedrol and was discharged on a tapering course of oral prednisone. He experienced improvement in his proptosis and ocular motility with stable vision.
Date 2019-03
Language eng
Format application/pdf
Type Text
Source 2019 North American Neuro-Ophthalmology Society Annual Meeting
Relation is Part of NAM 2019: Poster Session I: Clinical Highlights in Neuro-Ophthalmology
Collection Neuro-Ophthalmology Virtual Education Library: NANOS Annual Meeting Collection: https://novel.utah.edu/collection/nanos-annual-meeting-collection/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s66m7r7g
Setname ehsl_novel_nam
ID 1432240
Reference URL https://collections.lib.utah.edu/ark:/87278/s66m7r7g
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