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Neuropathology Of Neuro-Ophthalmic Disorders
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Optic neuritis (ON) is defined as the inflammation and swelling of the optic nerve. It is a common disease and affects individuals between 15 and 45 years of life, more so the females. It is classified according to etiology of neuritis such as autoimmunity, demyelination, infection or collagen vascular diseases.13 It may also be classified according to the anatomical location of lesions in the optic pathway such as optic papillitis or retrobulbar neuritis. Rapid diagnosis of etiology of ON is of utmost importance because precise treatment, prevention of organ damage and prognosis depends on etiology. The accurate diagnosis requires considerable evaluation including neuroimaging and CSF examination.
Vestibular Disorders and Rehabilitation
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Clinical assessment of the nystagmus and head impulse abnormality, supplemented by vestibular diagnostic tests (video head-impulse test, caloric, ocular, and cervical video evoked myogenic potential) can allow the differentiation into isolated superior or inferior vestibular nerve pathology, or complete varieties (see Chapter 5). These subtypes have differing presentations, prognoses, and rates of complications such as benign paroxysmal positional vertigo (BPPV). Imaging is usually normal, although in exceptional cases neuritis can be seen on magnetic resonance imaging (MRI).
Peripheral Nerve Examination
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Mohammed Tahir Ansari, Santanu Kar, Devansh Goyal, Dyuti Deepta Rano, Rajesh Malhotra
In some cases, it is seen that partial damage of the nerve fibres leads to neuritis. The tingling experienced by the patient with neuritis is very painful or there might be a painful swelling present. The clinician must be cautious to differentiate between neuritic pain and a tingling sensation due to nerve fibre regeneration. On serial examination over months, the neuritic pain is usually diminished in intensity and replaced with tingling sensation on percussion on the nerve trunk. Another important differentiating feature is the neuritic pain is often disabling in comparison to the tingling sensation of nerve regeneration.
Linezolid-related adverse effects in the treatment of rifampicin resistant tuberculosis: a retrospective study
Published in Journal of Chemotherapy, 2023
Dan Cui, Xiaomeng Hu, Li Shi, Dongchang Wang, Gang Chen
During the treatment courses, the types and occurrence of adverse effects among these patients were summarized in the Table 2. Generally, nine adverse effects, including leukopenia, hemochromatosis, thrombocytopenia, nausea and vomiting, optic neuritis, peripheral neuritis, hepatic injury, renal impairment, and rash, were included in this study. The results indicated that peripheral neuritis (51, 27.7%) and hemochromatosis (42, 22.8%) were the most frequently occurred adverse effects. The median time of the peripheral neuritis and hemochromatosis occurrence was 120.0 (90.0–165.0) and 45.5 (26.8–140.0) days, respectively. Meanwhile, the average time was 143.5 ± 97. and 90.8 ± 94.8 days, respectively. On the contrary, the hepatic injury (4, 2.2%), nausea and vomiting (4, 2.2%) and renal impairment (2, 1.1%) was the least observed adverse effects. The median time of the occurrence was 42.0 (21.0–48.0), 44.0 (17.5–82.5) and 70.0 (56.0–84.0) days, respectively, while the average time was 37.0 ± 15.8, 48.0 ± 34.0 and 70.0 ± 19.8 days, respectively. The leukopenia (16, 8.7%), thrombocytopenia (11, 6.0%), optic neuritis (14, 7.6%), and rash (8, 4.3%) were observed at an average time of 75.8 ± 88.7, 59.9 ± 92.6, 262.1 ± 184.7, and 79.5 ± 119.7 days, respectively. Collectively, these results showed that peripheral neuritis and hemochromatosis should be paid more attentions in the LZD treatment for patients with the rifampicin-resistant tuberculosis.
Atypical Case of MOG Antibody-Associated Optic Neuritis with Roth Spots
Published in Ocular Immunology and Inflammation, 2023
Jennifer Aboab, Marie-Hélène Errera, Sophie Espinoza, Jean-François Girmens, Emmanuel Héron
Another report from literature describes optic disc edema and retinal dot hemorrhages associated with cases of MOG optic neuritis.4 The hypothesis is that venous stasis might cause the retinal hemorrhage. Moreover, the retinal hemorrhages seemed to be associated with the optic neuritis since no hemorrhage was noted in the fellow eye. Venous stasis retinopathy and/or a limited retinal vein occlusion due to voluminous swelling of the optic nerve might explain these retinal hemorrhages and Roth spots. Unfortunately, an arterio-venous time was not available on the fluorescein angiogram to confirm this hypothesis, but the tortuous and dilated appearance of the veins in the affected eye compared to the fellow eye suggests the presence of venous stasis retinopathy. The diagnosis of inflammatory optic neuritis was related to the presence of painful eye and MRI enhanced hyperintensity of the optic nerve. Finally, the diagnosis was confirmed due to the high specificity of serum MOG antibodies.
An Atypical Case of Enterovirus Meningitis Presenting with Unilateral Optic Disc Swelling and Minimal Optical Symptoms
Published in Ocular Immunology and Inflammation, 2023
Efthymios Karmiris, Georgios Vasilakos, Konstantinos Tsiripidis, Evangelia Chalkiadaki
Optic disc swelling may be a presentation of benign conditions as in pseudopapilledema, or it can be a characteristic presentation of various diseases such as intrinsic ocular disease, intracranial lesions and systemic diseases.1 Optic neuritis, a common etiologic process of disc swelling, is defined as inflammation of the optic nerve. It describes a common pathological phenotype which could be idiopathic or result from a broad range of diseases, including demyelinating disorders such as multiple sclerosis or neuromyelitis optica, inflammatory, autoimmune or infectious disorders.2 A wide variety of viral, bacterial, parasitic and fungal agents can cause optic neuropathy, with variable clinical features. Proper clinical diagnosis of any specific infectious condition is based on epidemiological data, history, systemic symptoms and signs, and the pattern of optic nerve involvement and associated ocular findings, which can be confirmed by laboratory testing.3