Tissue Is the Issue (PDF)

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Identifier walsh_2020_s2_c4-pdf
Title Tissue Is the Issue (PDF)
Creator Christine Greer, Jasmine Francis, Eli Diamond, Charles Eberhart, Marc Dinkin
Subject Optic Neuritis, MRI, Horizontal Gaze Palsy
Description A 34-year-old man with a past medical history of bilateral corneoscleral lesions and brainstem, thalamic, and temporal lobe lesions presented with progressive vision loss over seven months. He described graying out of vision with light sensitivity. Bilateral, retrobulbar, deep ocular pain started 2 months ago but otherwise he denied headache. He endorsed baseline foreign body sensation. His ophthalmologic exam was notable for bilateral count fingers vision, normal IOP, pupils were round and reactive with no rAPD. His extraocular motility was significant for a bilateral gaze palsy. His slit lamp exam was notable for a gelatinous infiltrate circumferentially around the corneal limbus nasally on the right eye and 360 degrees around the left, but the visual axis remained clear. He had grade two posterior subcapsular cataracts and his dilated fundus exam was notable for diffusely pale optic nerves with; a normal cup-to-disc ratio of 0.3. Cranial nerves III-XII were otherwise intact. On neurologic exam, he was oriented to person, place, time. His recent and remote memory was intact. He exhibited a normal fund of knowledge and awareness of current events. His speech fluency difficult to assess because of profound dysarthria. Sensation was normal to light touch. Motor exam was significant; for L arm 3/5 in deltoid 4/5 triceps and 1 in wrist and fingers. Coordination was poor, patient could not perform finger to nose. Reflexes were 3+ throughout, with the exception of 4+ with clonus in the left patella. The left toe was upgoing. MR orbits showed enhancement of bilateral optic nerves with edema and enhancing lesions were present within the pons and the left mesial temporal lobe. He was admitted for workup and intravenous steroids.
Date 2020-03
Language eng
Format application/pdf
Source 2020 North American Neuro-Ophthalmology Society Annual Meeting
Relation is Part of NANOS Annual Meeting 2020: Frank B. Walsh Session 2
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
Rights Management Copyright 2020. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6xq2gq3
Contributor Primary Christine Greer
Contributor Secondary Jasmine Francis, Eli Diamond, Charles Eberhart, Marc Dinkin
Setname ehsl_novel_fbw
ID 1546636
Reference URL https://collections.lib.utah.edu/ark:/87278/s6xq2gq3
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