Neuroretinitis in a young woman

Margolin, Edward; Jeeva-Patel, Trishal

doi:10.1016/j.ensci.2020.100280

Cited by 7 publications

(20 citation statements)

References 5 publications

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“…Notably, neuroretinitis is not often associated with pain on EOM, which typically helps to distinguish its presentation from that of optic neuritis. 5 Fundoscopic findings consistent with neuroretinitis include optic disk edema and lipid exudation. Eventually, imaging will reveal a canonical “macular star” pattern which may be absent early in the disease process.…”

Section: Discussionmentioning

confidence: 99%

A 13-Year-Old Girl With Unilateral Visual Changes

Sykes

Joseph

Williams

et al. 2023

Journal of Investigative Medicine High Impact Case Reports

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Neuroretinitis is a condition typically characterized by unilateral optic neuropathy and is most commonly a sequelae of cat scratch disease (CSD) due to infection with Bartonella henselae. Ophthalmologic examination will reveal a swollen optic nerve and may eventually reveal a canonical macular star; optical coherence tomography (OCT) will reveal flattening of the fovea, a thickened neurosensory retina, and subretinal fluid accumulation. Although CSD rarely presents with isolated neuorretinitis, it should be considered in patients presenting with unilateral visual changes. The differential diagnosis for neuroretinitis includes optic neuritis, inflammatory optic neuropathies (sarcoid, para-infectious, autoimmune), compressive, toxic, and more. We describe a pediatric patient presenting with visual changes that were initially concerning for optic neuritis and the diagnostic workup that ultimately led to a diagnosis of CSD neuroretinitis.

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Section: Discussionmentioning

confidence: 99%

A 13-Year-Old Girl With Unilateral Visual Changes

Sykes

Joseph

Williams

et al. 2023

Journal of Investigative Medicine High Impact Case Reports

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show abstract

“…It is also important to consider alcohol, amphetamines, phencyclidine, lithium, selective serotonin reuptake inhibitors (SSRIs), and other toxins as potential causes. Negative findings for investigating the above conditions should prompt further investigation for underlying malignancy with CT imaging and a PET scan should be considered if CT is inconclusive [14]. The presence of the anti-Ri onconeural antibody is highly suggestive of OMS and can aid in the diagnosis, but other reports have shown that this is variable.…”

Section: Discussionmentioning

confidence: 99%

Breast Cancer Presenting As Onconeural Antibody Negative Opsoclonus-Myoclonus Syndrome

Soares¹,

Mittapalli²,

Ramakrishnan³

et al. 2022

Cureus

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Breast cancer can rarely present with or be preceded by paraneoplastic syndromes such as opsoclonus-myoclonus syndrome (OMS). OMS is a rare neurological syndrome that commonly presents with symptoms of rapid, chaotic eye movements (opsoclonus), jerking involuntary muscle movements (myoclonus) and is frequently associated with ataxia. We describe a case of a woman in her early 50s who presented to the emergency room (ER) with vertigo, jerking movements, loss of fine motor skills and gait abnormalities. She was initially thought to have likely vestibular neuritis and was treated symptomatically and discharged home. However, the symptoms persisted and she presented once again to the ER, at which time she also incidentally discovered a lump in her breast. This led to her being investigated more extensively leading to a diagnosis of underlying primary breast cancer. Based on her neurological clinical findings, she was diagnosed with onconeural antibody negative OMS. Treatment of her underlying malignancy led to a significant improvement in her symptoms. Paraneoplastic neurological syndromes (PNSs) are an important differential diagnosis to consider in patients presenting with persistent, treatment-resistant and non-specific neurological symptoms. Any suspicion of the same should prompt a search for an underlying malignancy that could greatly influence patient outcomes.

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“…These movements occur at a high frequency of 10-25 Hz and have an amplitude of 5-10 degrees. Opsoclonus worsens with fixation or random movement and continues during sleep or eyelid closure (13) . Patients frequently complain of oscillopsia, blurred vision, and vertigo as a result of this condition.…”

Section: Presentation and Diagnosismentioning

confidence: 99%

Adult-onset idiopathic opsoclonus-myoclonus syndrome

Zhang

Yan

Song

et al. 2023

ABO

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Opsoclonus-myoclonus syndrome is extremely uncommon in adults with an autoimmune pathophysiology. Because of the rarity of the syndrome, international recognition of opsoclonus-myoclonus-ataxia syndrome needs to be improved urgently. Therefore, the goal of this study was to raise the awareness of the opsoclonus-myoclonus-ataxia syndrome and help doctors in better diagnosing and using immunotherapy. Methods: We present a case study of an adult-onset case of idiopathic opsoclonus-myoclonus syndrome characterized by spontaneous arrhythmic multidirectional conjugate eye movements, myoclonus, ataxia, sleep disorders, and intense fear. Additionally, we conduct a literature search and summarize the pathophysiology, clinical presentation, diagnosis, and treatment of opsoclonus-myoclonus-ataxia syndrome. Results: Immunotherapies successfully treated the patient's opsoclonus, myoclonus, and ataxia. Further, the article also includes an update summary of the opsoclonus--myoclonus-ataxia syndrome. Conclusion: The prevalence of residual sequela in adults with opsoclonus-myoclonus-ataxia syndrome is low. Early diagnosis and treatment may result in a better prognosis. Furthermore, combined immunotherapy is expected to reduce the incidence of refractory and reoccurring opsoclonus-myoclonus-ataxia syndrome.

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Neuroretinitis in a young woman

Cited by 7 publications

References 5 publications

A 13-Year-Old Girl With Unilateral Visual Changes

A 13-Year-Old Girl With Unilateral Visual Changes

Breast Cancer Presenting As Onconeural Antibody Negative Opsoclonus-Myoclonus Syndrome

Adult-onset idiopathic opsoclonus-myoclonus syndrome

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