A Case of Ischemic Cerebral Infarction Associated with Acute Posterior Multifocal Placoid Pigment Epitheliopathy, CNS Vasculitis, Vitamin B&lt;sub&gt;12&lt;/sub&gt; Deficiency and Homocysteinemia

Kawi, Ammar Al; Wang, David Z.; Kishore, Kamal; Kattah, Jorge C.

doi:10.1159/000080975

Cited by 12 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most severe neurological complication we witnessed was stroke caused by histologically proven cerebral vasculitis. In a Medline search, we found 31 APMPPE patients with neurological manifestations [2, 3, 11–18]. Cerebral stroke occurred in 16 cases.…”

Section: Discussionmentioning

confidence: 99%

Ocular outcome and frequency of neurological manifestations in patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE)

Thomas

Jacobi

Korporal

et al. 2012

J Ophthal Inflamm Infect

View full text Add to dashboard Cite

PurposeThe purpose of this study was to describe the visual prognosis as well as the frequency and clinical severity of central nervous system involvement in all acute posterior multifocal placoid pigment epitheliopathy (APMPPE) patients of one centre.MethodsA retrospective database review of all patients and a prospective clinical, ophthalmological and neurological follow-up, if possible, were conducted.ResultsEighteen patients with APMPPE were included with a mean follow-up of 17.1 months. Thirteen patients participated in a follow-up exam. Visual acuity improved in 9 of 18 patients to a mean of 0.17 log minimum angle of resolution (MAR) in the worse eye and remained stable in eight patients (mean, 0.03 logMAR). In the majority of patients, the 30° static perimetry improved at follow-up compared to the initial exams. Still, in up to 50 to 60 %, small visual field defects persisted. Overall, 11 patients (61 %) showed neurologic symptoms of varying severity. The most common neurological symptom was headache in nine (50 %) patients. Other symptoms included paraesthesias, psychosis, vertigo, and, as the most severe complication, stroke due to cerebral vasculitis. Fifteen patients were treated with systemic corticosteroids.ConclusionsVisual prognosis is good in patients with APMPPE, but visual field defects may remain. Neurological signs and symptoms, especially headaches, are frequent in APMPPE and should be taken seriously. Adequate investigations including MRI and CSF examination should be initiated in these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Ocular outcome and frequency of neurological manifestations in patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE)

Thomas

Jacobi

Korporal

et al. 2012

J Ophthal Inflamm Infect

View full text Add to dashboard Cite

show abstract

“…3 Of interest is the observed onset of neurologic symptoms with tapering of the oral corticosteroid dose, a phenomenon noted by other investigators. 4,5 Although the visual sequelae of APMPPE often resolve without permanent deficits in visual acuity, the condition may be associated with a wide range of central nervous system findings, including life-threatening cerebral vasculitis. The most common neurologic manifestation is headache accompanied by cerebrospinal fluid pleocytosis.…”

Section: Discussionmentioning

confidence: 99%

Acute Posterior Multifocal Placoid Pigment Epitheliopathy and Thalamic Infarction

Yunker¹,

Ready²,

Tucker³

et al. 2008

RETINAL Cases &Amp; Brief Reports

View full text Add to dashboard Cite

show abstract

“…Of the patients presenting with cerebrovascular complications 11/31 (35%) had evidence of a possible vasculitis on MR angiography or catheter angiography. Formal catheter angiography has shown evidence of small vessel disease with findings of diffuse narrowing, segmental narrowing and in some cases a typical beading appearance [3,10,12,14,19,23,29].…”

Section: Neurological Complications Of Amppementioning

confidence: 99%

Neurological complications of acute multifocal placoid pigment epitheliopathy

Brownlee

Anderson

Sims

et al. 2016

Journal of Clinical Neuroscience

View full text Add to dashboard Cite

Acute multifocal placoid pigment epitheliopathy (AMPPE) is an autoimmune chorioretinal disease that can be complicated by neurological involvement. There is limited information on this potentially treatable condition in the neurological literature. The objective of this patient series is to describe the neurological complications of AMPPE. We retrospectively identified patients with neurological complications of AMPPE seen at Auckland Hospital between 2008 and 2013 and summarised cases in the literature between 1976 and 2013. We identified five patients with neurological complications of AMPPE at Auckland Hospital and 47 reported patients. These patients demonstrated a spectrum of neurological involvement including isolated headache, stroke or transient ischaemic attack, seizures, venous sinus thrombosis, optic neuritis, sensorineural hearing loss and peripheral vestibular disorder. We propose criteria to define AMPPE with neurological complications. A cerebrospinal fluid (CSF) lymphocytosis in a patient with isolated headache may predict the development of cerebrovascular complications of AMPPE. Patients with cerebrovascular complications of AMPPE have a poor prognosis with high rates of death and neurological disability among survivors. Predictors of poor outcome in those who develop neurological complications of AMPPE are a relapsing course, generalised seizures and multifocal infarction on MRI. All patients with neurological complications of AMPPE, including headache alone, should be investigated with an MRI brain and CSF examination. Patients with focal neurological symptoms should receive intravenous (IV) methylprednisolone followed by a tapering course of oral steroids for at least 3months. Patients with AMPPE and an isolated headache with a CSF pleocytosis should be treated with oral steroids.

show abstract

A Case of Ischemic Cerebral Infarction Associated with Acute Posterior Multifocal Placoid Pigment Epitheliopathy, CNS Vasculitis, Vitamin B<sub>12</sub> Deficiency and Homocysteinemia

Cited by 12 publications

References 8 publications

Ocular outcome and frequency of neurological manifestations in patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE)

Ocular outcome and frequency of neurological manifestations in patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE)

Acute Posterior Multifocal Placoid Pigment Epitheliopathy and Thalamic Infarction

Neurological complications of acute multifocal placoid pigment epitheliopathy

Contact Info

Product

Resources

About