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Title | Creator | History |
226 |
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Looking for a Drop of Porcelain - Abstract | Shannon J. Beres, Grant T. Liu, MD, Professor of Neurology, University of Pennsylvania | A 4 year old healthy boy presented with severe headache. A right subdural hygroma was seen on brain MRI and CSF evaluation showed a leukocytosis with elevated protein. A week later he developed left leg weakness and a repeat brain MRI showed progressive leptomeningeal enhancement and new punctate in... |
227 |
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Eyes and Bowels Bottled Up - Presentation PPT | Kristopher Kowal, Jonathan Daniel Trobe, MD, Michigan University, Theodore T. Brown | A 56 year-old man presented with diplopia and ptosis. Actually he was more concerned about severe constipation that had started about the same time. Abdominal x-rays had shown stool loading; laxatives had been ineffective. Our exam showed bilateral ptosis with complete ophthalmoplegia in both eyes. ... |
228 |
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Eyes and Bowels Bottled Up - Abstract | Kristopher Kowal, Jonathan Daniel Trobe, MD, Michigan University, Theodore T. Brown | A 56 year-old man presented with diplopia and ptosis. Actually he was more concerned about severe constipation that had started about the same time. Abdominal x-rays had shown stool loading; laxatives had been ineffective. Our exam showed bilateral ptosis with complete ophthalmoplegia in both eyes. ... |
229 |
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Eyes and Bowels Bottled Up - Path PPT | Kristopher Kowal, Jonathan Daniel Trobe, MD, Michigan University, Theodore T. Brown | A 56 year-old man presented with diplopia and ptosis. Actually he was more concerned about severe constipation that had started about the same time. Abdominal x-rays had shown stool loading; laxatives had been ineffective. Our exam showed bilateral ptosis with complete ophthalmoplegia in both eyes. ... |
230 |
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The Man with No Face (About Face) | Michael S. Vaphiades, MD, University of Alabama | A 61-year-old man presented with one week history of decreased vision OS. Past medical historyincludes asthma and amblyopia OD, but with complete visual loss OD 18 years prior. He takes nomedications. He is retired but worked for 21 years in social science research. The remarkable thingupon meeting ... |
231 |
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Growing Suspicion | Angela M. Herro | A 44 year-old man presented to the emergency department in July 2011 for progressive painless visionloss in the right eye for 3 months. On presentation, vision was 4/200 in the right and 20/20 in the leftwith an afferent pupillary defect on the right. His visual field was full to confrontation but a... |
232 |
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Three Weeks in Florida | Andrew R. Carey | A 36 year-old man presented with severe headaches, bilateral leg numbness, and bilateral decreasedvision. He was born in Ecuador where he received BCG vaccination and immigrated to US at age 19. In2005 he enrolled in nursing school and volunteered in homeless shelters. PPD was positive with anegativ... |
233 |
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Under Pressure | Nathan H. Kung | A 29-year-old woman was referred to neuro-ophthalmology clinic for 1 year of headaches andpapilledema discovered 2 months earlier. She complained of recently blurred vision but no positionalheadache, pulsatile tinnitus, transient visual obscurations, or other neurologic issues. She used nomedication... |
234 |
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Hiding and Out of Sight | Michael L. Morgan | A 75-year-old white woman presented with a history of biopsy-proven giant cell arteritis (GCA)presented with recurrence of severe left sided headaches and left global ophthalmoparesis for 4 days.GCA had been diagnosed 4 months prior by biopsy. Left eye vision loss occurred when an outsidephysician t... |
235 |
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A Shot in the Dark | Joshua Pasol | History & ExamA 74 year-old man with a chief complaint of difficulty with night time driving for several years as wellas difficulty going from a lighted room to a dark room. PMH of high cholesterol, BPH, hypothyroidism,GERD, glottic squamous cell cancer without recurrence, and a prior history of alc... |
236 |
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Requim for a Cabinet Maker | Jennifer I. Doyle | A 54-year-old white male presents with 3 weeks of painless horizontal nystagmus and 6 months of leftsided forehead numbness. He reports a 20 lbs weight loss. Medical history includes a renal transplant 30years prior. He takes prednisone 30 mg QOD and azathioprine. Visual acuity is 20/20 OU, color vi... |
237 |
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Shady Double Crosser | Francine Wein | A 62-year-old woman presented with a one-month history of severe light sensitivity and headache, and atwo week history of diplopia. Her photophobia was severe enough for her to wear sunglasses indoors.Her past medical history was significant for a cholecystectomy and Crohns disease, for which she ha... |
238 |
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Using Muscle | Nagham Al-Zubidi | 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... |
239 |
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Who Deserves a Second Chance? | Lina Nagia | An 81-year-old woman presents with a one-month history of blurred vision OS, acutely worse in thepast 5 days. She reports pain with left gaze, left sided forehead tenderness and some weightloss. Medical history includes hypertension, borderline diabetes, cerebral vascular accident and basalcell carc... |
240 |
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A Weak Presentation | Reuben M. Valenzuela | An 82-year-old right-handed man with myasthenia gravis presented in May 2014 with double vision andright facial numbness and weakness. He was first seen in 1998 with horizontal diplopia. He had anabduction deficit of the right eye, and right nasolabial fold flattening. He was diagnosed withmyastheni... |
241 |
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Star Spangled Banne | Dara M. Bier | A 12-year-old girl with a history of bilateral optic nerve enlargement, enterovirus meningitis, seizures,and bilateral hygromas, presented with acute onset chronic vision loss in her left eye. Two years prior,she presented to an outside hospital with headaches, intermittent speech arrest and right-s... |
242 |
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Nobody's Perfect | Alexander Ksendzovsky | In June of 2006 an 8 year old patient was referred for evaluation. Apparently at age 1she haddeveloped headaches and was found to have a posterior fossa tumor. In El Salvador she was treatedwith shunting and chemotherapy plus radiation therapy for presumed medulloblastoma. She underwenta shunt revis... |
243 |
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I Can't See Straight | Steven A. Newman | In May of 2014 this 30 year old right handed patient was referred for consultation regarding diplopiaand dizziness. The patient relates that she had been told that she had tired eyes as a child. Two and ahalf years ago she began to have intermittent exodeviation. She was seen locally and diagnosed a... |
244 |
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Lights Out | John J. Brinkley | A 78 year-old man presented with a one-month history of progressive painless binocular vision loss. Hehad sustained head trauma without loss of consciousness three days prior to the onset of vision loss. Onthe morning of his presentation to us, he had awoken with complete binocular vision loss and h... |
245 |
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It's Not Just a FAD, (EHR Fatigue Syndrome) | Jacqueline A. Leavitt | A 29 year-old female nurse, nine months postpartum, presented with an inability to see her computerwell for the past two months. She denied eye pain, diplopia, numbness, tingling or weakness. Therewere no changes in vision in bright vs. dim lighting. She also had a headache at the back of her head f... |
246 |
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Now you see it. Now you don't. | Prem S. Subramanian | A 70 yo RH African American female presented to our institution with sequential, severe vision loss inthe preceding 4 months. Her past medical history included well-controlled hypertension andhyperlipidemia, CAD s/p coronary stent placement x 2 after MI, and stroke. She had no prior history ofvisual... |
247 |
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Some Like it Hot | Ahmara G. Ross | History & ExamA 71 year old Caucasian man with a past medical history of hypertension, hyperlipidemia, Type 2 DM,ESRD status post renal transplant, facial melanoma, currently on ASA for a stable left sided putaminalhemorrhage presented with new right sided ptosis and lower extremity weakness. Brain ... |
248 |
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Speakeasy | Joseph G. Chacko | A 64 year-old Caucasian gentleman presented with an unusual complaint. He stated that if he touchedthe inside of his right cheek with his tongue, he felt a tingly sensation in his R eyebrow. This had startedone month ago. He also complained of foreign body sensation and discomfort in the right eye f... |
249 |
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Joe & Jerry Flew the Coop | Lulu L. C. D. Bursztyn | A previously healthy 13-year-old girl presented to a local hospital with fever and myalgia, followed oneday later by lethargy and vision loss. Past medical history was significant only for acne, for which shehad been treated with doxycycline 40 mg/day intermittently starting 2 months prior to sympto... |
250 |
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The Relationship Between PDE-5 Inhibitors and NAION | Howard D. Pomeranz, MD | Sildenafil was first synthesized by pharmaceutical chemists working at Pfizer. It was initially studied for use in hypertension and angina. Phase I clinical trials suggested that the drug had little effect on angina but could induce penile erection. Sildenafil (Viagra®) was patented in 1996 and app... |