Identifier |
walsh_2013_s2_c4-1 |
Title |
Is it Naughty or Nice? |
Creator |
Daniel Gold; Madhura Tamhankar; Laura Balcer; Thomas Coyne; Clyde Markowitz; Steven Galetta |
Affiliation |
(DG) (MT) (LB) (SG) University of Pennsylvania, Departments of Neurology and Ophthalmology, Philadelphia, PA; (TC) University of Pennsylvania, Department of Pathology, Philadelphia, PA; (CM) University of Pennsylvania, Department of Neurology, Philadelphia, PA |
Subject |
Anterior optic neuritis; Ring-enhancing lesions; Fulminant MS |
History |
Subjective fever and cold symptoms were noted 3 weeks prior, and she had experienced transient visual obscurations for 2 weeks. |
Pathology |
Neuropathology showed vast areas of confluent demyelination, marked histiocytic infiltrates, perivascular lymphocytic cuffs, and numerous Creutzfeldt cells - suggestive of acute fulminant MS (Marburg variant), neuropathology did not show multifocal inflammation and demyelination centered around venous structures, which would be expected in ADEM. |
Disease/Diagnosis |
Acute fulminant MS (Marburg disease) |
Clinical |
Visual acuity was 20/400 OD and CF at 1 foot OS with dyschromatopsia, left RAPD and bilateral severe optic disc swelling with hemorrhages; large multifocal ringenhancinglesions with surrounding vasogenic edema centered around the gray-white junction, and bilateral opticnerve enhancement. |
Presenting Symptom |
A 19-year-old woman presented with 4 days of rapidly progressive vision loss in both eyes associated with pain on eye movements. |
Neuroimaging |
CT Scan; MRI |
Date |
2013-02 |
References |
1. Beck RW, et al. High- and low-risk profiles for the development of multiple sclerosis within 10 years after optic neuritis: experience of the optic neuritis treatment trial.Arch Ophthalmol 2003;121(7):944-949. 2. Hu W, Lucchinetti CF. The pathological spectrum of CNS inflammatory demyelinating diseases. Semin Immunopathol 2009;31:439-453. 3. Johnson MS, Lee MS, Younge BR, Purvin V. Multiple Sclerosis on Steroids. Surv Ophthalmol 2010;55(5):460-466. |
Language |
eng |
Format |
application/pdf |
Format Creation |
Microsoft PowerPoint |
Type |
Text |
Source |
45th Annual Frank Walsh Society Meeting |
Relation is Part of |
NANOS Annual Meeting Frank B. Walsh Sessions; 2013 |
Collection |
Neuro-Ophthalmology Virtual Education Library: Walsh Session Annual Meeting Archives: https://novel.utah.edu/Walsh/ |
Publisher |
North American Neuro-Ophthalmology Society |
Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
Rights Management |
Copyright 2013. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
ARK |
ark:/87278/s6031p23 |
Setname |
ehsl_novel_fbw |
ID |
179159 |
Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6031p23 |