| Identifier |
walsh_2015_s4_c3-2 |
| Title |
Using Muscle |
| Creator |
Nagham Al-Zubidi |
| Subject |
Anisocoria; Ocular Pain; MRI; Special Staining; Amyloidosis |
| History |
A 30- year-old Saudi female student with no past medical history presented an eight month history ofprogressive blurred vision primarily at near, anisocoria OS, and periocular discomfort with eyemovements. Neuro-Ophthalmologic examination revealed best corrected visual acuity of OD 20/20 andOS 20/30. Color vision was OD 12/12 and OS 12/12. Automated threshold perimetry was normal.The pupils were 4 mm and normally reactive OD and 5 mm and minimally reactive OS. There was norelative afferent pupil defect (RAPD). The pupil was characteristic of absent sympathetic andparasympathetic input as may be seen in cavernous sinus lesions. The eyes were quiet. IOP was normal.Ocular motility examination was normal at initial evaluation but over the next 3 months she developedlimited adduction and mild proptosis; other eye movements were normal throughout her 10 monthcourse. Funduscopy was normal. Magnetic resonance imaging (MRI) of the brain and orbit withcontrast revealed an enlarged left medial rectus and a linear enhancing structure running from the medialrectus muscle back to the superior orbital fissure and superior lateral wall of the cavernous sinus,believed to be an enlarged, enhancing third nerve. The following laboratory studies were performed andwere negative or normal: Angiotensin-converting enzyme, lysozyme, T4, T3, TSH, thyroid stimulatingimmunoglobulin, thyrotropin binding inhibitory immunoglobulins, thyroid peroxidase antibody, serumprotein electropheresis, cysticercosis antibodies, trichinella immunoglobulin G, and IgG4immunoglobulin. A Quantiferon Gold test was sent three times before receiving a report that it waspositive after all the above evaluation and the diagnostic procedure were complete. A diagnosticprocedure was done |
| Date |
2015-02-22 |
| Language |
eng |
| Format |
application/pdf |
| Type |
Text |
| Source |
2015 North American Neuro-Ophthalmology Society Annual Meeting |
| Relation is Part of |
NANOS Annual Meeting Frank B. Walsh Sessions; 2015 |
| 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 2013. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6h73cdn |
| Contributor Primary |
Leah N. Levi |
| Contributor Secondary |
Elizabeth M. Palkovacs |
| Setname |
ehsl_novel_fbw |
| ID |
179302 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6h73cdn |
