Is it Naughty or Nice?

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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
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