11/349. Toxic optic neuropathy after concomitant use of melatonin, zoloft, and a high-protein diet.melatonin is a neuromodulating hormone found in the pineal gland and retina. It is involved in light-dark circadian rhythms and mediates retinal processes in a manner antagonistic to that of dopamine. Zoloft (sertraline) is an antidepressant drug that blocks the reuptake of serotonin at the neural synapse. serotonin is the natural precursor of melatonin. A 42-year-old woman sought treatment for visual acuity loss, dyschromatopsia, and altered light adaptation. Neuro-ophthalmologic examination was otherwise normal except for evolving bilateral cecocentral scotomas. She had taken Zoloft for 4 years and began a high-protein diet with melatonin supplementation 2 weeks before onset of visual symptoms. visual acuity and color vision improved within 2 months after melatonin and the high-protein diet were discontinued. Combined use of melatonin, Zoloft, and a high-protein diet may have resulted in melatonin/dopamine imbalance in the retina, manifesting as a toxic optic neuropathy. physicians and patients should be alerted to this potential drug interaction.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
12/349. Visual recovery after a year of craniopharyngioma-related amaurosis: report of a nine-year-old child and a review of pathophysiologic mechanisms.BACKGROUND: The probability of visual recovery in tumor-related optic neuropathy usually correlates with the severity and duration of optic pathway compromise. Recovery of visual acuity to normal levels is unexpected after profound loss of vision extending for a period of weeks and months. methods: A 9-year-old girl who had neurosurgical resection of a craniopharyngioma compressing the optic chiasm and optic tract was followed up serially with neuroimaging and clinical examinations over a 6-year period. RESULTS: Within 3 months of the diagnosis of craniopharyngioma, the girl's vision was reduced to no-light-perception blindness when she viewed with the more involved eye. The blindness correlated with an amaurotic (i.e., >3.6 log unit) relative afferent pupillary defect and an absence of any response when tested with visual field perimetry. After more than a year of total blindness and cessation of all neurosurgical and radiation therapy, visual acuity recovered to a normal level (20/25), the afferent pupillary defect improved, and sensitivity in a portion of the temporal hemivisual field was restored. In the follow-up that has extended for 5 years from the time of recovery, stability of the restored vision has been documented. CONCLUSION: Children who have tumor-related loss of vision due to damage to the anterior visual pathways may be capable of recovery after intervals of blindness that would be considered irreversible in adults. The mechanism of the recovery in our patient may have been decompression-related restoration of axoplasmic flow, followed by gradual remyelination of visual fibers, which allowed reorganization of connections to the lateral geniculate nucleus to optimize synaptic transmission.- - - - - - - - - - ranking = 0.2keywords = neuropathy (Clic here for more details about this article) |
13/349. Chiasmopathy?A 57-year-old man presented with progressive visual loss in both eyes, bitemporal field defect, and a history of poor nutrition, alcohol abuse, and excessive cigar smoking. magnetic resonance imaging was normal. The visual acuity and field defect improved with supplementation with vitamins and reduction of alcohol and tobacco consumption. A diagnosis of toxic optic neuropathy was made. The authors discuss the differential diagnosis of bitemporal/pseudobitemporal field defects and the diagnosis and treatment of toxic optic neuropathy.- - - - - - - - - - ranking = 0.4keywords = neuropathy (Clic here for more details about this article) |
14/349. MR characteristics of muslin-induced optic neuropathy: report of two cases and review of the literature.Muslin-induced optic neuropathy is a rarely reported but important cause of delayed visual loss after repair of intracranial aneurysms. Most of the previously reported cases were published before the introduction of MR imaging. We describe the clinical features and MR appearance of two cases of delayed visual loss due to "muslinoma," and compare them with the 21 cases reported in the literature.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
15/349. Traumatic carotid artery dissection causing blindness.A case of delayed postoperative visual loss due to bilateral traumatic carotid artery dissection is presented. In patients with a major craniofacial injury due to a high-speed motor vehicle accident, we suggest that carotid artery duplex ultrasonography be used in the initial evaluation for possible carotid artery dissection. magnetic resonance imaging of the head and neck with magnetic resonance angiography should be performed subsequently if indicated. early diagnosis and initiation of therapy can minimize complications.- - - - - - - - - - ranking = 5.3396517573519E-6keywords = motor (Clic here for more details about this article) |
16/349. septo-optic dysplasia plus: a spectrum of malformations of cortical development.The authors describe three children with septo-optic dysplasia (SOD)-plus: SOD and an associated malformation of cortical development. All three children had developmental delay, and two of the children had significant associated motor deficits. The associated cortical malformations with SOD include a spectrum of disorders of neuronal organization, not limited, as previously described, to schizencephaly. SOD-plus should be suspected in children with SOD and developmental delay.- - - - - - - - - - ranking = 5.3396517573519E-6keywords = motor (Clic here for more details about this article) |
17/349. A case of bilateral optic neuropathy in a patient on tacrolimus (FK506) therapy after liver transplantation.PURPOSE: To report a case of bilateral optic neuropathy in a patient receiving tacrolimus (FK 506, Prograf; Fujisawa USA, Inc, Deerfield, illinois) for immunosuppression after orthotropic liver transplantation. METHOD: Case report. In a 58-year-old man receiving tacrolimus after orthotropic liver transplantation, serial neuro-ophthalmologic examinations and laboratory studies were performed. RESULTS: The patient had episodic deterioration of vision in both eyes, with clinical features resembling ischemic optic neuropathies. Deterioration of vision occurred despite discontinuation of the tacrolimus. CONCLUSION: tacrolimus and other immunosuppressive agents may be associated with optic nerve toxicity.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
18/349. Bilateral optic neuropathy associated with diffuse cerebral angiomatosis in sturge-weber syndrome.Visual loss in patients with encephalotrigeminal angiomatosis or sturge-weber syndrome usually results from secondary glaucoma or from damage to the retrogeniculate pathways by the angiomatous lesions. Optic neuropathy has not been reported as a component of this syndrome. This report describes a patient who developed bilateral optic neuropathy with progressive visual loss associated with diffuse cerebral angiomatosis in the setting of sturge-weber syndrome.- - - - - - - - - - ranking = 1.2keywords = neuropathy (Clic here for more details about this article) |
19/349. Reversal of dysthyroid optic neuropathy following orbital fat decompression.AIMS: To document the successful treatment of five patients with dysthyroid optic neuropathy by orbital fat decompression instead of orbital bone decompression after failed medical therapy. methods: Eight orbits of five patients with dysthyroid optic neuropathy were selected for orbital fat decompression as an alternative to bone removal decompression. Treatment with systemic corticosteroids and/or orbital radiotherapy was either unsuccessful or contraindicated in each case. All patients satisfied clinical indications for orbital bone decompression to reverse the optic neuropathy. High resolution computerised tomographic (CT) scans were performed in all cases and in each case showed signs of enlargement of the orbital fat compartment. As an alternative to bone decompression, orbital fat decompression was performed on all eight orbits. RESULTS: Orbital fat decompression was performed on five patients (eight orbits) with optic neuropathy. Optic neuropathy was reversed in all cases. There were no cases of postoperative diplopia, enophthalmos, globe ptosis, or anaesthesia. All patients were followed for a minimum of 1 year. CONCLUSIONS: In a subset of patients with an enlarged orbital fat compartment and in whom extraocular muscle enlargement is not the solitary cause of optic neuropathy, fat decompression is a surgical alternative to bony decompression.- - - - - - - - - - ranking = 2keywords = neuropathy (Clic here for more details about this article) |
20/349. Acute optic neuropathy and transverse myelopathy in patients with antiphospholipid antibody syndrome: favorable outcome after treatment with anticoagulants and glucocorticoids.We describe two patients with established antiphospholipid syndrome, who during periods of subtherapeutic anticoagulation, developed acute optic neuropathy and transverse myelopathy. Treatment with optimal anticoagulation and high dose glucocorticoids was followed by resolution of the neurologic deficits.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
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