Cases reported "Recurrence"

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11/21. Devic's neuromyelitis optica treated with intravenous gamma globulin (IVIG).

    BACKGROUND: Devic's syndrome is a demyelinating disease of the spinal cord and optic nerves. It tends to have a poor prognosis, probably due to the occurrence of necrosis within lesions. There is no proven effective treatment although relapses are commonly treated with corticosteroids and people with recurrent attacks may be managed with chronic immune suppressing treatments. Intravenous gamma globulin (IVIG) and plasma exchange are reasonable treatment options because Devic's syndrome is believed to be antibody mediated. We report two patients of Devic's syndrome that stabilized following initiation of monthly IVIG. PATIENT 1: A 42-year-old woman with a 23 year history of Devic's syndrome continued to have frequent attacks of optic neuritis unresponsive to daily corticosteroids and azathioprine. Since initiation of monthly IVIG 5 1/2 years ago she has had no further definite attacks. She has also noted minimal improvement in color perception. PATIENT 2: A 58-year-old woman with a three year history of Devic's syndrome experienced five attacks during the first 16 months of disease. Monthly IVIG was associated with complete cessation of relapses and significantly improved neurological status over one year of treatment. CONCLUSIONS: Because active Devic's disease often results in severe, permanent neurological impairment, preventive intervention should be considered. These cases suggest that IVIG may be effective in preventing attacks and possibly in enhancing neurological recovery. Randomized controlled trials will be needed to confirm this and to determine optimal dosing and treatment duration.
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ranking = 1
keywords = neuromyelitis optica, neuromyelitis, optica
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12/21. neuromyelitis optica in a child with atypical onset and severe outcome.

    We report on a seven-year-old boy with inflammatory relapsing-remitting CNS disease, involving the optic nerves and spinal cord, with increasingly severe sequelae after each relapse. Clinical course, neuroimaging and laboratory findings were consistent with neuromyelitis optica. biopsy of leptomeninges and underlying nervous tissue showed increased vascularization and thickened hyalinized vessel walls, reported as suggestive for neuromyelitis optica. Clinical features at onset were atypical, rendering the case highly unusual and the diagnosis tentative.
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ranking = 0.5566733964707
keywords = neuromyelitis optica, neuromyelitis, optica
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13/21. Recurrent neuromyelitis optica with diffuse central nervous system involvement: case report.

    Several demyelinating disorders can affect children. The differential diagnosis between these diseases is usually an arduous task. Diagnostic criteria have been proposed for some of these disorders, however most of them have not yet been clinically and prospectively validated. Here we present a case of a ten year-old boy with recurrent bilateral optic neuritis and spinal cord involvement. Clinical and cerebrospinal fluid data have fulfilled diagnostic criteria for Devic's neuromyelitis optica (NMO). The differential diagnosis with multiple sclerosis (MS) has become troublesome since not only optic nerves and spinal cord were involved. In one of the relapses a left hemiparesis with facial involvement was registered. magnetic resonance imaging was also compatible with MS. This case illustrates that CNS demyelinating disorders can fulfill diagnostic criteria for more than one demyelinating disease, making the clinical judgment an important tool in the management of these patients.
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ranking = 1.25
keywords = neuromyelitis optica, neuromyelitis, optica
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14/21. Nd:YAG laser treatment of recalcitrant folliculitis decalvans.

    BACKGROUND: The scarring follicular disorders pose challenging therapeutic dilemmas. OBJECTIVE: hair removal lasers have recently been shown to be efficacious in the management of these disorders. methods: We present a young, Fitzpatrick skin type VI African-American patient with recalcitrant folliculitis decalvans, whom we treated with the neodymium:yttrium aluminum garnet (Nd:YAG) laser. RESULTS: A remission of folliculitis decalvans was successfully achieved using the Nd:YAG for laser depilation. CONCLUSION: Based on the optical properties of light in skin, the Nd:YAG laser is the best for laser depilation in dark individuals.
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ranking = 0.014168349117675
keywords = optica
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15/21. Idiopathic severe recurrent transverse myelitis: a restricted variant of neuromyelitis optica.

    Recurrent idiopathic transverse myelitis occur in multiple sclerosis (MS) and neuromyelitis optica (NMO). In NMO, acute optic neuritis and myelitis occur, either monophasic or relapsing, without clinical manifestations of involvement of other parts of the central nervous system (CNS). Recent evidence suggests that NMO is different from multiple sclerosis. The authors reported two patients having severe recurrent transverse myelitis sparing the optic nerves and cerebral hemispheres. Both patients had longitudinally extensive myelitis in some attacks with poor neurological outcome despite aggressive immunomodulatory therapy. One patient had prominent clinical features of brainstem injury with radiological and histological confirmation of brainstem involvement, and the other patient had trigeminal neuralgia suggestive of possible brainstem dysfunction. Histologically, prominent necrosis and neutrophilic infiltration of spinal cord tissue without eosinophils or hyalinized vessels were observed, and oligoclonal bands were absent in their cerebrospinal fluid. It is likely to be a distinct idiopathic inflammatory demyelinating disorder restricted to the spinal cord and brainstem different from MS, but within the spectrum of NMO with probably an autoimmune basis.
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ranking = 1.25
keywords = neuromyelitis optica, neuromyelitis, optica
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16/21. Recurrent retinal angiomatous proliferation after surgical ablation.

    PURPOSE: To report a case of retinal angiomatous proliferation (RAP) treated by ablation of the feeding and draining vessels that recurred by 6 months postoperatively. DESIGN: Interventional case report. methods: Images from fluorescein angiography, indocyanine green (ICG) angiography, and optical coherence tomography (OCT) were examined before and after ablation. RESULTS: The hot spot on late-phase ICG, the leakage on fluorescein angiography, the pigment epithelial detachment, and macular edema on OCT decreased postoperatively. However, a large hyperfluorescent lesion was detected on ICG 6 months postoperatively with recurrent cystoid macular edema. CONCLUSIONS: A new RAP lesion can develop even after the original lesion seemed to resolve after ablation.
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ranking = 0.014168349117675
keywords = optica
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17/21. Late reopening and spontaneous closure of previously repaired macular holes.

    PURPOSE: The features of late reopening with spontaneous closure in previously repaired macular holes are illustrated with optical coherence tomography (OCT). DESIGN: Observational case reports. methods: Case study of two patients with reopened macular holes that developed 7 years after successful macular hole surgery and then spontaneously closed while patients were awaiting surgery. RESULTS: OCT imaging demonstrated reduction in the cystic spaces within the leaves of the macular hole followed by bridging of the hole in one patient. The second patient had abrupt closure of the hole with resolution of the cystic spaces. Subsequent normalization of the foveal contour was observed in both patients. CONCLUSION: OCT imaging accurately demonstrated the features of spontaneous closure of late reopened macular holes. Possible mechanisms for this rare event are discussed and compared with the characteristics of spontaneously closed primary and traumatic macular holes.
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ranking = 0.014168349117675
keywords = optica
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18/21. Optical coherence tomography findings after an intravitreal injection of bevacizumab (avastin) for macular edema from central retinal vein occlusion.

    To determine whether bevacizumab could improve visual acuity and optical coherence tomography outcomes in a patient with macular edema from central retinal vein occlusion, an intravitreal injection of bevacizumab (1.0 mg) was given. Prior intravitreal injections of triamcinolone acetonide resulted in vision improvement but worsening cataract and borderline glaucoma. Within 1 week of the bevacizumab injection, visual acuity improved from 20/200 to 20/50 and optical coherence tomography revealed resolution of the cystic maculopathy. The improvements were maintained for at least 4 weeks. intravitreal injections of bevacizumab may provide another treatment option for patients with macular edema from vein occlusions.
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ranking = 0.02833669823535
keywords = optica
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19/21. Recurrent optic neuromyelitis with endocrinopathies: a new syndrome or just a coincidence?

    The spectrum of optic neuromyelitis (ONM) ranges from monophasic or recurrent idiopathic forms of the disease, to ONM associated with autoimmune disorders. A distinct form of the disease, called recurrent ONM with endocrinopathies, characterized by spinal cord involvement (cavitations with syringomyeloid sensory disturbance), rapid evolution to blindness and paraplegia, characteristic cerebrospinal fluid (CSF) findings, and association with hypothalamus-pituitary dysfunction, has recently been described. The first case of ONM with endocrinopathies in a female Caucasian from europe is presented, supporting the existence of this syndrome as a separate entity.
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ranking = 0.39203326254131
keywords = neuromyelitis
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20/21. neuromyelitis optica: two new cases and review of the literature.

    The clinical features of two recent cases of neuromyelitis optica are reviewed, along with 43 cases from the literature. Severe bilateral visual impairment, thoracic myelitis, prodromal symptoms suggesting a viral syndrome, and moderate pleocytosis of the cerebrospinal fluid (CSF) were characteristic. Respiratory failure developed in 22% of the cases. Seventy percent of patients improved neurologically, 14% had a poor neurological outcome, and 16% died in the acute stages. Predictors of a poor outcome were older age, marked CSF pleocytosis, and severe myelitis. Forty-two percent of patients had a recurrence of demyelinating disease after initial recovery, suggesting a diagnosis of multiple sclerosis. Fifty-eight percent of patients had a self-limited monophasic illness, consistent with a post-infectious encephalomyelitis. No clear predictors of patients at risk for recurrence were identified. CSF oligoclonal bands were absent in three patients with information available.
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ranking = 0.3066733964707
keywords = neuromyelitis optica, neuromyelitis, optica
(Clic here for more details about this article)
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