| Identifier |
walsh_2013_s2_c2 |
| Title |
Deaf and Dizzy. Have We Been Susacked? |
| Creator |
Jorge C. Kattah, John H. Pula, Paayal K. Patel, Meena Gujrati, David Newman-Toker, MD, PhD, Associate Professor, Departments of Neurology, Ophthalmology, & Otolaryngology, The Johns Hopkins University School of Medicine |
| Subject |
Intravascular Lymphoma; Cerebral Microangiopathy; Deafness; Acute Vestibular Syndrome; Encephalopathy |
| History |
Acute vestibular syndrome (AVS) with unsteadiness, nausea, vomiting and decreased hearing. He is diabetic, has arterial hypertension, and was taking losartan, metformin, clopidogrel, and atorvastatin but was not on ototoxic or vasodilators medications. Examination at presentation showed left axial lateropulsion, a right beat, horizontal, unidirectional nystagmus in primary, right and up gaze, and a positive left horizontal head impulse test (h-HIT). |
| Pathology |
Cerebral biopsy, which established the diagnosis of intravascular lymphoma. |
| Disease/Diagnosis |
Intravascular Lymphomatosis; Anterior Ischemic Optic Neuropathy |
| Clinical |
The h-HIT device measured 0.49 (abnormal) left and 0.89 (normal) right gains Overt, corrective saccades were observed with horizontal left head accelerations; without skew deviation. Eye examination showed normal visual acuity, color vision and visual fields by confrontation, right optic nerve surface drusen, a normal left optic nerve, bilaterally normal macula, peripheral retina and branch retinal arteries, normo-reactive pupils without APD, and normal biomicroscopy without uveitis. |
| Presenting Symptom |
A 60 year old man had an acute myelopathy in December 2010, with normal neuroimaging and spinal fluid (CSF). |
| Neuroimaging |
CT Scan; MRI |
| Treatment |
Rituximab; Methotrexate; CHOP |
| Date |
2013-02-10 |
| References |
Attached |
| Language |
eng |
| Format |
application/pdf |
| Type |
Text |
| Source |
45th Annual Frank Walsh Society Meeting |
| Relation is Part of |
Case presented at the NANOS 2013 Walsh Session, February 10 |
| 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), Copyright 2013. For further information regarding the rights to this collection, please visit http://library.med.utah.edu/NOVEL |
| ARK |
ark:/87278/s6f21w8z |
| Contributor Primary |
Kedar, Sachin |
| Contributor Secondary |
Rucker, Janet C |
| Setname |
ehsl_novel_fbw |
| ID |
179171 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6f21w8z |
