Deaf and Dizzy. Have We Been Susacked?

Update item information
Identifier walsh_2013_s2_c2
Title Deaf and Dizzy. Have We Been Susacked?
Creator Kattah, Jorge C; Pula, John H; Patel, Paayal K; Gujrati, Meena; 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
Presenting Symptom A 60 year old man had an acute myelopathy in December 2010, with normal neuroimaging and spinal fluid (CSF).
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).
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.
Neuroimaging CT Scan; MRI
Pathology Cerebral biopsy, which established the diagnosis of intravascular lymphoma.
Disease/Diagnosis Intravascular Lymphomatosis; Anterior Ischemic Optic Neuropathy
Treatment Rituximab; Methotrexate; CHOP
References Attached
Relation is Part of Case presented at the NANOS 2013 Walsh Session, February 10
Contributor Primary Kedar, Sachin
Contributor Secondary Rucker, Janet C
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2013-02-10
Type Text
Format application/pdf
Source 45th Annual Frank Walsh Society Meeting
Holding Institution North American Neuro-Ophthalmology Association (NANOS), Copyright 2013. For further information regarding the rights to this collection, please visit
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s6f21w8z
Setname ehsl_novel_fbw
Date Created 2013-12-12
Date Modified 2021-05-06
ID 179171
Reference URL
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