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TitleCreatorHistory
51 Orbiting a DiagnosisDaniel Liebman; Daniel Lefebvre; Emily Tam; Marie Lithgow; Bart Chwalisz; Eric Gaier; Joseph KaneA 68 -year-old right -handed man presented for evaluation of progressive and fluctuating polyopia, gait instability and cognitive changes of about 14 months. Prior medical history was notable for Crohn's disease in remission, atrial fibrillation, a single episode of aseptic meningitis 12 years prior...
52 Oh My GAD!! Something Else?Olwen Murphy; Kemar Green; John Probasco; Daniel GoldA 43 -year-old man presented with oscillopsia, dizziness, binocular vertical diplopia, and gait difficulties. He reported a six-month history of abdominal pain, anorexia and 50-pound weight loss, and a 3-month history of mood and cognitive changes. Torsional nystagmus, a left 4th nerve palsy (NP), u...
53 Bones of the Past (PDF)Bart Chwalisz; Konstantinos Douglas; Vivian Douglas; Otto RapalinoA 44-year-old woman presented with two episodes of binocular horizontal diplopia within one year. She had a history of Cushing's syndrome status post transsphenoidal resection and bilateral adrenalectomy 4 years prior, hypertension, and secondary diabetes mellitus. Nine months prior she developed se...
54 Bones of the Past (Slides)Bart Chwalisz; Konstantinos Douglas; Vivian Douglas; Otto RapalinoA 44-year-old woman presented with two episodes of binocular horizontal diplopia within one year. She had a history of Cushing's syndrome status post transsphenoidal resection and bilateral adrenalectomy 4 years prior, hypertension, and secondary diabetes mellitus. Nine months prior she developed se...
55 Tumefictive MS (PDF)Anthony Brune III; Hemant Parmar; Sandra Camelo-Piragua; Lindsey De LottA 26-year-old woman with history of diabetes insipidus and hypothyroidism presented for evaluation of painless vision loss in her right eye. She was evaluated by a local neurologist and multiple sclerosis (MS) specialist who diagnosed acute optic neuritis. MRI brain showed an enhancing T2 hyperinten...
56 Tumefictive MS (Slides)Anthony Brune III; Hemant Parmar; Sandra Camelo-Piragua; Lindsey De LottA 26-year-old woman with history of diabetes insipidus and hypothyroidism presented for evaluation of painless vision loss in her right eye. She was evaluated by a local neurologist and multiple sclerosis (MS) specialist who diagnosed acute optic neuritis. MRI brain showed an enhancing T2 hyperinten...
57 Are We 'Tilting At Windmills'? (Video)Michael VaphiadesA 52-year-old African American woman presented to her primary care physician with a 4 week history of headaches, nausea, vomiting, fever and ataxia. Her medical history includes rheumatoid arthritis, hypertension and a recent diagnosis of pulmonary; sarcoidosis for which she was taking 20 mg of pred...
58 Look in the Back (Video)Tatiana Deveney; Aristides Capizzano; Jonathan TrobeA 59-year old man with Graves disease developed increasing proptosis and diplopia. Attributing these abnormalities to worsening of the Graves disease, an ophthalmologist treated him with high-dose oral and intravenous corticosteroids. When improvement did not occur, he underwent orbital x-irradiatio...
59 Are We 'Tilting At Windmills'? (PDF)Michael VaphiadesA 52-year-old African American woman presented to her primary care physician with a 4 week history of headaches, nausea, vomiting, fever and ataxia. Her medical history includes rheumatoid arthritis, hypertension and a recent diagnosis of pulmonary; sarcoidosis for which she was taking 20 mg of pred...
60 Look in the Back (PDF)Tatiana Deveney; Aristides Capizzano; Jonathan TrobeA 59-year old man with Graves disease developed increasing proptosis and diplopia. Attributing these abnormalities to worsening of the Graves disease, an ophthalmologist treated him with high-dose oral and intravenous corticosteroids. When improvement did not occur, he underwent orbital x-irradiatio...
61 Objects Jumping, Body Bumping, Hearing Slumping…Quick, He is Crumping (PDF)Jorge Kattah; Scott Eggers; Sarah BachA 45 y/o man developed insidious unsteadiness and bilateral hearing impairment. A neurosurgeon diagnosed possible myelopathy, and despite an anterior cervical discectomy, he noted progressive gait difficulty, poor handwriting, and inability to play the guitar. Additionally, dysarthria, oscillopsia a...
62 From Brainstem to Stern (Slides)Neena Cherayil; Angela Viane; Grant Liu; Ali HamedaniA previously healthy 32-year-old man complained of diplopia and one month of worsening positional headaches. He then acutely developed confusion and chills, prompting ER referral. Further history was limited by altered mental status. On presentation, he was afebrile and encephalopathic. Serum WBC wa...
63 A Myel-In, a Long Way to Go (Slides)Aishwarya Pareek; Timothy Lotze; Gail Demmler; Brandon Tran; William Whitehead; Carrie Mohila; Veeral ShahA 9-year-old previously healthy female with two recent admissions for presumed diagnosis of ADEM re-presented with persistent headache and ataxic gait. During her initial admissions, she presented with fever, acute onset of ataxia, facial asymmetry and abnormal eye movements. Inpatient ocular exam s...
64 Are We 'Tilting At Windmills'? (Slides)Michael VaphiadesA 52-year-old African American woman presented to her primary care physician with a 4 week history of headaches, nausea, vomiting, fever and ataxia. Her medical history includes rheumatoid arthritis, hypertension and a recent diagnosis of pulmonary; sarcoidosis for which she was taking 20 mg of pred...
65 Objects Jumping, Body Bumping, Hearing Slumping…Quick, He is Crumping (Slides)Jorge Kattah; Scott Eggers; Sarah BachA 45 y/o man developed insidious unsteadiness and bilateral hearing impairment. A neurosurgeon diagnosed possible myelopathy, and despite an anterior cervical discectomy, he noted progressive gait difficulty, poor handwriting, and inability to play the guitar. Additionally, dysarthria, oscillopsia a...
66 Look in the Back (Slides)Tatiana Deveney; Aristides Capizzano; Jonathan TrobeA 59-year old man with Graves disease developed increasing proptosis and diplopia. Attributing these abnormalities to worsening of the Graves disease, an ophthalmologist treated him with high-dose oral and intravenous corticosteroids. When improvement did not occur, he underwent orbital x-irradiatio...
67 A Myel-In, a Long Way to Go (Video)Aishwarya Pareek; Timothy Lotze; Gail Demmler; Brandon Tran; William Whitehead; Carrie Mohila; Veeral ShahA 9-year-old previously healthy female with two recent admissions for presumed diagnosis of ADEM re-presented with persistent headache and ataxic gait. During her initial admissions, she presented with fever, acute onset of ataxia, facial asymmetry and abnormal eye movements. Inpatient ocular exam s...
68 From Brainstem to Stern (Video)Neena Cherayil; Angela Viane; Grant Liu; Ali HamedaniA previously healthy 32-year-old man complained of diplopia and one month of worsening positional headaches. He then acutely developed confusion and chills, prompting ER referral. Further history was limited by altered mental status. On presentation, he was afebrile and encephalopathic. Serum WBC wa...
69 A Myel-In, a Long Way to Go (PDF)Aishwarya Pareek; Timothy Lotze; Gail Demmler; Brandon Tran; William Whitehead; Carrie Mohila; Veeral ShahA 9-year-old previously healthy female with two recent admissions for presumed diagnosis of ADEM re-presented with persistent headache and ataxic gait. During her initial admissions, she presented with fever, acute onset of ataxia, facial asymmetry and abnormal eye movements. Inpatient ocular exam s...
70 Smoke Gets in Your Eyes (PDF)Tatiana Bakaeva; John Gittinger, JrA 61-year-old woman, active smoker with history of COPD, presented with bilateral progressive vision loss and ataxia. Four months prior to her presentation she developed 'black spot' in her right eye (OD) and was found to have 'OD disc edema and right hypertropia' by an outside ophthalmologist. She ...
71 Oh Oh Oh It's Magic, You Know…Never Believe It's Not So! (PDF)Zeeshan Haq; Jeremy Tanner; Christine Glastonbury; Cathryn Cadwell; Brooks Crawford; Elan Guterman; Maulik Shah; Megan Richie; Nailyn RasoolA 72-year-old man with chronic sinusitis, obstructive sleep apnea, and recent extensive travel presented with right-sided headaches, vision changes, and allergy symptoms. A head CT demonstrated a sinus infection and he was treated with amoxicillin-clavulanate; and prednisone. His headache persisted ...
72 Smoke Gets in Your Eyes (Video)Tatiana Bakaeva; John Gittinger, JrA 61-year-old woman, active smoker with history of COPD, presented with bilateral progressive vision loss and ataxia. Four months prior to her presentation she developed 'black spot' in her right eye (OD) and was found to have 'OD disc edema and right hypertropia' by an outside ophthalmologist. She ...
73 Oh Oh Oh It's Magic, You Know…Never Believe It's Not So! (Video)Zeeshan Haq; Jeremy Tanner; Christine Glastonbury; Cathryn Cadwell; Brooks Crawford; Elan Guterman; Maulik Shah; Megan Richie; Nailyn RasoolA 72-year-old man with chronic sinusitis, obstructive sleep apnea, and recent extensive travel presented with right-sided headaches, vision changes, and allergy symptoms. A head CT demonstrated a sinus infection and he was treated with amoxicillin-clavulanate; and prednisone. His headache persisted ...
74 Bones of the Past (Video)Bart Chwalisz; Konstantinos Douglas; Vivian Douglas; Otto RapalinoA 44-year-old woman presented with two episodes of binocular horizontal diplopia within one year. She had a history of Cushing's syndrome status post transsphenoidal resection and bilateral adrenalectomy 4 years prior, hypertension, and secondary diabetes mellitus. Nine months prior she developed se...
75 Undiscovered Islands - So Close, Yet So Far (PDF)Magdalena Wirth; Farahna Sabiq; Mehdi AgoumiA 30-year old female, visiting Canada from India, presented to ophthalmology with a 2-day history of right periorbital swelling, painful proptosis, fevers and chills. Initial examination suggested a clinical diagnosis of post-septal cellulitis with mild motility restriction, without optic nerve comp...
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