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Isolated Vertical Gaze Palsy due to Unilateral Rostral Midbrain Stroke. 单侧后脑中风导致的孤立性垂直凝视麻痹
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-07 DOI: 10.1097/WNO.0000000000002281
João Cláudio C Urbano, Sara C de Souza, César C B Lopes, Guilherme D Silva, Adalberto Studart-Neto, Fernando Freua, Luiz R Comerlatti
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引用次数: 0
Idiopathic Intracranial Hypertension Induced Cervical Syringomyelia and Cerebellar Tonsillar Ectopia Reversed With Venous Sinus Stenting. 静脉窦支架植入术逆转了特发性颅内高压引起的颈椎鞘膜积液和小脑扁桃体外翻。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-23 DOI: 10.1097/WNO.0000000000002222
Joshua Pasol, Eric C Peterson
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引用次数: 0
Ophthalmoplegia Associated With Extramedullary Multiple Myeloma: Case Series From a Tertiary Cancer Center. 髓外多发性骨髓瘤相关性眼瘫:一家三级癌症中心的病例系列。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-23 DOI: 10.1097/WNO.0000000000002076
Ujalashah Dhanani, Peter W Mortensen, Subahari Raviskanthan, Andrew G Lee, Andrew T Whyte, Dan S Gombos, Nagham Al-Zubidi

Background: Multiple myeloma (MM) is a malignant disorder of plasma cells that results in tumor cells replacing the bone marrow. In extramedullary MM (EMM), however, tumor cells proliferate outside the bone marrow. EMM may produce ophthalmoplegia through direct invasion of the superior orbital fissure, cavernous sinus, and/or sphenoidal sinus. Several mechanisms have been proposed including cranial nerve palsies, direct infiltration of bone, extraocular muscle metastasis, myelomatous meningitis, and parenchymal or paraneoplastic effects.

Methods: We retrospectively reviewed the medical records of 7 patients at MD Anderson Cancer Center who suffered from ophthalmoplegia secondary to extramedullary MM between 2019 and 2021. We collected information regarding the symptoms, signs, radiographic and laboratory findings, management, complications, and prognosis of these patients throughout their disease course.

Results: Skull base MRI revealed 4 patients with ophthalmoplegias secondary to superior orbital fissure invasion, 2 patients with ophthalmoplegias secondary to cavernous sinus invasion, and 1 patient with ophthalmoplegia secondary to sphenoid sinus invasion.

Conclusions: This is a case series describing 7 patients with ophthalmoplegias secondary to EMM. Our article is unique because of the size of the included cohort, which is large when compared with most English language publications detailing such ophthalmoplegias.

背景:多发性骨髓瘤(MM)是一种浆细胞恶性疾病,会导致肿瘤细胞取代骨髓。但在髓外骨髓瘤(EMM)中,肿瘤细胞在骨髓外增殖。髓外MM可能通过直接侵犯眶上裂、海绵窦和(或)蝶窦而导致眼球震颤。目前提出的几种机制包括颅神经麻痹、骨骼直接浸润、眼外肌转移、骨髓瘤性脑膜炎、实质或副肿瘤性影响:我们回顾性地查看了2019年至2021年期间MD安德森癌症中心7名继发于髓外MM的眼肌麻痹患者的病历。我们收集了这些患者在整个病程中的症状、体征、影像学和实验室检查结果、处理、并发症和预后等信息:颅底磁共振成像显示,4名患者因眶上裂受侵而继发眼球震颤,2名患者因海绵窦受侵而继发眼球震颤,1名患者因蝶窦受侵而继发眼球震颤:这是一个病例系列,描述了7名继发于EMM的眼肌麻痹患者。我们的文章之所以独特,是因为所纳入的患者群规模很大,与大多数详细描述此类眼球震颤的英文出版物相比,我们的患者群规模更大。
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引用次数: 0
Seesaw Nystagmus and Internuclear Ophthalmoplegia From Paramedian Pontine Infarction. 旁侧桥脑梗塞引起的眼球震颤和核内眼球震颤
IF 2.9 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-10 DOI: 10.1097/wno.0000000000002247
Benjamin Nham,Miranda Morrison,Miriam S Welgampola
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引用次数: 0
Macular Optical Coherence Tomography Findings in Patients With Syphilitic Optic Neuropathy-A Case Series and Systematic Review. 梅毒性视神经病变患者的黄斑光学相干断层扫描结果--病例系列和系统综述
IF 2.9 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-10 DOI: 10.1097/wno.0000000000002188
Irina Sverdlichenko,Heather M McDonald,Jim Shen Chu Xie,Edward A Margolin
BACKGROUNDSyphilis is a sexually or congenitally acquired infectious disease that can affect multiple organs systems, including the eye. When left undiagnosed and untreated, it can lead to significant morbidity and mortality. Syphilitic optic neuropathy can be difficult to diagnose because it can mimic many other nonsyphilitic causes of optic nerve involvement, leading to delay in treatment. Diagnosing ocular syphilis may be facilitated by assessing for specific outer retina abnormalities on macular optical coherence tomography (OCT).METHODSThis was a case series and case-based systematic review. For the case series, a retrospective chart review was conducted of all patients who presented to a tertiary university-affiliated neuro-ophthalmology practice over 6 months with undifferentiated optic neuropathy and were eventually diagnosed with syphilitic optic neuropathy. For the systematic review, OVID MEDLINE, EMBASE, and COCHRANE CENTRAL databases were searched to identify all cases of syphilitic optic neuropathy with macular OCT. The primary research outcome was the prevalence of cases with outer retinal abnormalities on OCT.RESULTSFour cases were identified that were eligible for inclusion. The ages ranged from 27 to 62 years old, and 2 of the patients were female. On examination, vision ranged from Snellen 20/50 to hand motion; all patients had optic neuropathy, and macular OCT revealed chorioretinitis characterized by retinal pigment epithelium (RPE) excrescences. The patients subsequently underwent uveitis workup and were diagnosed with syphilis. They were treated with intravenous penicillin and showed improvement in outer retina appearance on follow-up. The systematic review consisted of 24 cases and 35 eyes with syphilitic optic neuropathy and reported macular OCT findings. Eighty-three percent (20/24) were males, and the mean age was 47.7 years (SD: 49.2). The mean visual acuity at presentation was Snellen 20/57. On fundoscopy, 25.7% (9/35) of eyes had vitritis, whereas 22.8% (8/35) had placoid chorioretinal lesions. On OCT, 45.7% (16/35) of eyes had abnormal outer retina findings, most commonly disruption of the ellipsoid zone (EZ) and/or RPE excrescences. All patients were treated with penicillin or ceftriaxone, and final mean visual acuity was Snellen 20/29.CONCLUSIONSAll 4 patients identified in the case series, and nearly half of patients with syphilitic optic neuropathy described in the literature had concurrent-specific outer retina abnormalities (disruption of EZ and/or placoid chorioretinitis in the form of RPE excrescences) seen on macular OCT. We recommend that clinicians obtain macular OCT for all patients presenting with undifferentiated optic neuropathy.
背景梅毒是一种通过性途径或先天性获得的传染性疾病,可影响包括眼睛在内的多个器官系统。如果不及时诊断和治疗,会导致严重的发病率和死亡率。梅毒性视神经病变可能很难诊断,因为它可能与许多其他非梅毒性视神经受累病因相似,从而导致治疗延误。通过黄斑光学相干断层扫描(OCT)评估特定的视网膜外层异常可能有助于诊断眼梅毒。在病例系列研究中,我们对所有在 6 个月内因未分化视神经病变到一所三级大学附属神经眼科就诊并最终被诊断为梅毒性视神经病变的患者进行了回顾性病历审查。为了进行系统性研究,研究人员检索了 OVID MEDLINE、EMBASE 和 COCHRANE CENTRAL 数据库,以确定所有伴有黄斑 OCT 的梅毒性视神经病变病例。主要研究结果是OCT显示视网膜外层异常病例的患病率。年龄从 27 岁到 62 岁不等,其中 2 名患者为女性。经检查,视力从斯奈伦20/50到手部运动不等;所有患者都有视神经病变,黄斑OCT显示脉络膜视网膜炎,其特征是视网膜色素上皮(RPE)脱落。患者随后接受了葡萄膜炎检查,并被确诊为梅毒。他们接受了静脉青霉素治疗,随访发现视网膜外层外观有所改善。系统性回顾包括24例梅毒性视神经病变患者和35只眼睛,并报告了黄斑OCT检查结果。83%(20/24)的患者为男性,平均年龄为 47.7 岁(标准差:49.2)。就诊时的平均视力为斯奈伦20/57。眼底镜检查结果显示,25.7%(9/35)的眼睛患有玻璃体炎,22.8%(8/35)的眼睛患有脉络膜病变。在光学视网膜扫描(OCT)中,45.7%(16/35)的眼睛视网膜外层出现异常,最常见的是椭圆形区(EZ)破坏和/或RPE赘生物。结论本病例系列中发现的所有 4 名患者以及文献中描述的近一半梅毒性视神经病变患者在黄斑 OCT 上都同时出现了特异性视网膜外层异常(EZ 破坏和/或以 RPE 视网膜赘生物形式出现的胎盘状脉络膜炎)。我们建议临床医生为所有出现未分化视神经病变的患者进行黄斑 OCT 检查。
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引用次数: 0
Analysis of Neuroradiologic Findings in Idiopathic Intracranial Hypertension-A Population-Based Study. 特发性颅内高压症的神经放射学发现分析--一项基于人群的研究
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-05 DOI: 10.1097/WNO.0000000000002248
Yael N Steinberg, Gregory J Parnes, Nilesh K Raval, Fernando M Pellerano Sosa, Afshin Parsikia, Joyce N Mbekeani

Background: Idiopathic intracranial hypertension (IIH) has been associated with several MRI features. We assessed types of MRI findings and clinical-radiologic correlations in patients with IIH from one hospital system.

Methods: A retrospective chart review of IIH and control patients was conducted. Brain MRI/magnetic resonance venogram features were enumerated and assessed for correlation with body mass index (BMI) and lumbar puncture opening pressure (LPOP). Sensitivity, specificity, positive predictive value (PPV), and likelihood ratios (LRs) were calculated for each MRI sign. Significance was set at P < 0.05.

Results: One hundred one patients diagnosed with IIH, and 119 control patients had complete files and were included. Patients with IIH were predominantly female (92.8% vs 59.7%; P = <0.001), younger (30.6 years vs 46.4 years; P < 0.001), and more obese (mean BMI = 35.2 vs 29.3; P < 0.001) than controls. Mean (SD) number of MRI findings was 2.21 (1.8) in IIH and 0.6 (1.2) in controls; (P < 0.001). Vertical nerve tortuosity (44.1%; P < 0.001), TVSS (37.8%; P < 0.001), sheath expansion (36.0%; P < 0.001), globe flattening (22.5%; P < 0.001), slit ventricles (18.9%; P < 0.001), optic disc protrusion (9.9%; P = 0.007), and complete empty sella (12.6%; P < 0.042) were observed more in patients with IIH than control patients. In the IIH group, mean (SD) LPOP was 33.6 (11.11) cmH2O and weakly correlated with number of MRI findings (rho = 0.182, P = 0.057). TVSS (sensitivity 37.84%; confidence interval [CI] 29.3%-47.2%, specificity 98.32%; CI 93.5%-99.6%) had the highest PPV (95.45%) and positive LR (22.51) for IIH diagnosis.

Conclusions: These results are consistent with IIH predominance in young, obese females. In patients with IIH, the number of MRI findings exceeded controls and positively correlated with LPOP. TVSS was most predictive of IIH.

背景:特发性颅内高压(IIH特发性颅内高压(IIH)与多种 MRI 特征有关。我们评估了一家医院系统 IIH 患者的 MRI 检查结果类型和临床放射学相关性:方法:我们对 IIH 患者和对照组患者进行了回顾性病历审查。方法:对 IIH 和对照组患者进行了回顾性病历审查,列举了脑部 MRI/磁共振静脉造影特征,并评估了这些特征与体重指数(BMI)和腰椎穿刺开口压(LPOP)的相关性。计算了每个 MRI 征象的敏感性、特异性、阳性预测值 (PPV) 和似然比 (LR)。显著性以 P < 0.05 为标准:1001例确诊为IIH的患者和119例有完整档案的对照组患者被纳入研究。IIH 患者以女性居多(92.8% 对 59.7%;P = 结论:IIH 患者以女性居多(92.8% 对 59.7%;P = 结论:IIH 患者以女性居多):这些结果与 IIH 患者以年轻、肥胖女性为主的情况一致。在 IIH 患者中,核磁共振成像结果的数量超过了对照组,并与 LPOP 呈正相关。TVSS最能预测IIH。
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引用次数: 0
Facial Colliculus and Sixth Nerve Nuclear Infarct as a Sentinel Sign of a Thrombosed Basilar Artery Aneurysm. 面神经丘和第六神经核梗塞是基底动脉瘤血栓形成的前哨信号
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-04 DOI: 10.1097/WNO.0000000000002243
Lisle Blackbourn, Amber Hughes, Jorge Kattah
{"title":"Facial Colliculus and Sixth Nerve Nuclear Infarct as a Sentinel Sign of a Thrombosed Basilar Artery Aneurysm.","authors":"Lisle Blackbourn, Amber Hughes, Jorge Kattah","doi":"10.1097/WNO.0000000000002243","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002243","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nasal Hemianopic Junctional Scotoma of Traquair Secondary to Chordoma. 继发于脊索瘤的鼻半月形交界性斯科拉瘤
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-04 DOI: 10.1097/WNO.0000000000002252
Ritu R Sampige, Tuan Anh Nguyen, Saif Aldeen Alryalat, Osama Al Deyabat, Andrew G Lee
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引用次数: 0
Etiologies and Outcomes of Granulomatosis With Polyangiitis-Associated Optic Neuropathy: A Case Series and Review of the Literature. 肉芽肿性多血管炎相关性视神经病变的病因和结果:病例系列和文献综述。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-04 DOI: 10.1097/WNO.0000000000002249
Abdul-Rahman Salman, Minjun Hur, Kenneth J Warrington, James A Garrity, Matthew J Koster, Kevin D Chodnicki, Deena A Tajfirouz, John J Chen

Background: Granulomatosis with polyangiitis (GPA), formerly known as Wegener granulomatosis, is a rare autoimmune disease characterized by inflammation of small- to medium-sized blood vessels (vasculitis). We described the 3 causes of GPA-associated optic neuropathy (compressive, inflammatory, or ischemic) and analyzed initial and final visual acuities (VAs) in each group, which could potentially help prognosticate visual outcomes depending on the etiology of optic neuropathy.

Methods: This was a retrospective chart review of patients who were diagnosed with GPA-associated optic neuropathy and were seen in the Department of Ophthalmology at Mayo Clinic in Rochester, Minnesota. Only patients who met the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology GPA classification criteria were included.

Results: A total of 12 patients with GPA-associated optic neuropathy were identified. The etiology of the optic neuropathy was compressive in 6 patients, inflammatory in 4 patients, and ischemic in 3 patients. One patient had compressive optic neuropathy initially, then presented with GPA-related optic neuritis years later. Four patients in the compressive optic neuropathy group had orbital masses requiring orbitotomy for debulking, and the remaining 2 patients had compression from pachymeningitis. Average logarithm of the minimum angle of resolution (logMAR) VA at optic neuropathy onset was 1.50, 1.50, and 0.67 (Snellen equivalent 20/600, 20/600, and 20/100, respectively). At the last follow-up, average logMAR VA was 0.91, 1.73, and 1.10 (Snellen equivalent 20/160, 20/1,000, and 20/250, respectively) for each group.

Conclusion: Visual outcomes were variable, with compressive and inflammatory optic neuropathies showing improvement in 4 eyes and worsening in 3 eyes in total. Patients with ischemic optic neuropathy from GPA were either stable or worsened over the course of the disease.

背景:肉芽肿伴多血管炎(GPA),以前称为韦格纳肉芽肿病,是一种罕见的自身免疫性疾病,以中小型血管的炎症(血管炎)为特征。我们描述了 GPA 相关性视神经病变的 3 种病因(压迫性、炎症性或缺血性),并分析了每组患者的初始和最终视力(VAs),这可能有助于根据视神经病变的病因预测视力预后:这是对明尼苏达州罗切斯特梅奥诊所眼科确诊为 GPA 相关性视神经病变患者的回顾性病历审查。只有符合2022年美国风湿病学会/欧洲风湿病学协会联盟GPA分类标准的患者才被纳入:结果:共发现12名GPA相关性视神经病变患者。6名患者的视神经病变病因为压迫性,4名患者为炎症性,3名患者为缺血性。一名患者最初为压迫性视神经病变,多年后出现了与 GPA 相关的视神经炎。压迫性视神经病变组中有 4 名患者有眼眶肿块,需要进行眼眶切开术进行剥离,其余 2 名患者的压迫性视神经病变是由帕奇脑膜炎引起的。视神经病变发病时的平均最小分辨角对数(logMAR)VA分别为1.50、1.50和0.67(斯奈伦等效视力分别为20/600、20/600和20/100)。最后一次随访时,各组的平均对数视力分别为0.91、1.73和1.10(斯奈伦视力等效值分别为20/160、20/1000和20/250):视力结果各不相同,压迫性和炎症性视神经病变共有4只眼睛的视力有所改善,3只眼睛的视力恶化。GPA引起的缺血性视神经病变患者在病程中要么病情稳定,要么恶化。
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引用次数: 0
Superior Oblique Palsy With Corresponding Eye Muscle Atrophy on MRI After Herpes Zoster Ophthalmicus. 带状疱疹眼炎后核磁共振成像显示上斜肌麻痹伴相应眼肌萎缩
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-04 DOI: 10.1097/WNO.0000000000002250
Joshua Pasol, Elena B Roth, Richard J T Gorniak, Ozlem Pala
{"title":"Superior Oblique Palsy With Corresponding Eye Muscle Atrophy on MRI After Herpes Zoster Ophthalmicus.","authors":"Joshua Pasol, Elena B Roth, Richard J T Gorniak, Ozlem Pala","doi":"10.1097/WNO.0000000000002250","DOIUrl":"https://doi.org/10.1097/WNO.0000000000002250","url":null,"abstract":"","PeriodicalId":16485,"journal":{"name":"Journal of Neuro-Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Neuro-Ophthalmology
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