| Identifier |
walsh_2001_s3_c1 |
| Title |
Rapidly Shifting into Third Gear |
| Creator |
Dina Jacobs, Steven Galetta, Clyde Markowitz, Robert Shin |
| Subject |
Multiple Sclerosis; Pupil Disorders; Facial Nerve Diseases; Demyelinating Diseases |
| History |
A 67-year old woman developed onset of visual loss in her left eye, 2 days after the resection of two basal cell carcinomas from her nose. |
| Pathology |
Infiltration of foamy macrophages and lymphocytes with numerouos reactive astrocytes in the right pontomedullary junction |
| Disease/Diagnosis |
Tumefactive multiple sclerosis |
| Clinical |
VA: 20/40 OD, Counting fingers OS |
| Presenting Symptom |
Loss of vision OS |
| Neuroimaging |
Brain MRI revealed a large heterogeneously enhancing periventricular left frontal lesion. Mild enhancement of the left optic nerve was also noted. MR spectroscopy was suspicious for a neoplastic lesion. |
| Treatment |
Steroids; Plasmapharesis |
| Date |
2001 |
| References |
1. Ernst T, Chang L, Walot I, Huff K. Physiologic MRI of a tumefactive multiple sclerosis lesion. Neurology 1998;51:1486-88. 2. Kepes, JJ. Large focal tumor-like dymyelinating lesions of the brain: intermediate entity between multiple sclerosis and acute disseminated encephalomyelitis? A study of 31 patients. Ann Neurol 1993;33:18-27. 3. Peterson K, Rosenblum MK, Powers JM, Alvord E, Walker RW, Posner JB. Effect of brain irradiation on dymyelinating lesions. Neurology 1993;43:2105-2112. 4. Youl BD, Kermode AG, Thompson AJ, Revesz T, Scaravilli F, Barnard RO, Kirkham FJ, Kendall BE, Kingsley D, Moseley IF, Stevens JM, Earl CJ, McDonald WI. Destructive lesions in demyelinating disease. J Neurology, Neurosurgery, Psychiatry 1991;54:288-292. 5. Dagher AP, Smirniotopoulos J. Tumefactive demyelinating lesions. Neuroradiology 1996;38:560-65. 6. Zagzag D, Miller DC, Kleinman GM, Abati A, Budzilovich GN. Disease versus tumor in surgical neuropathology. Clues to a correct pathological diagnosis. Amer J Surg Path 1993;17:537-45. 7. Ferguson JH, et al. Assessment of plasmapharesis. Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 1996;47:840-43. 8. Khatri BO, McQuillen MP, Harrington GJ, Schmoll D, Hoffmann RG. Chronic progressive multiple sclerosis: double-blind controlled study of plasmapharesis in patients taking immunosuppressive drugs. Neurology 1985;35:312-19. 9. Shah AK, Tselis A, Mason B. Acute disseminated encephalomyelitis in a pregnant woman successfully treated with plasmapharesis. J Neurological Sciences 2000;174:147-51. 10. Takahashi I, Sawaishi Y, Takeda O, Enoki M, Takada G. Childhood multiple sclerosis treated with plasmapharesis. Pediatr Neurol 1997;83-87. 11. Goodkin DE, Ransohoff FM, Rudick RA. Experimental therapies for multiple sclerosis: current status. Cleve Clin J Med 1992;59:63-74. 12. Weinshenker BG, O'Brien PC, Rodriguez M. A randomized trial of plasma exchange in acute central nervous demyelinating disease. Ann Neurology 1999;46:878-86. |
| Language |
eng |
| Format |
application/pdf |
| Type |
Text |
| Source |
27th Annual North American Neuro-Ophthalmology Society Meeting, Frank B. Walsh Session CD-ROM |
| Relation is Part of |
Case 1, Session III, Walsh Session, NANOS 2001 |
| 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 2008. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6222xg1 |
| Contributor Secondary |
Steven Galetta, M.D.; Clyde Markowitz, M.D.; Robert Shin, M.D.; Alex Judkins, M.D.; Peter Nelson, M.D., Ph.D. |
| Setname |
ehsl_novel_fbw |
| ID |
177710 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6222xg1 |
