In response to: Acute‐onset binocular diplopia in neurological unit

2021 ◽  
Author(s):  
Laura Donaldson ◽  
Edward Margolin
Keyword(s):  
Acute Onset ◽  
Binocular Diplopia ◽  
Neurological Unit

Acute‐onset binocular diplopia in neurological unit: Aetiological factors and diagnostic assessment

2021 ◽  
Author(s):  
Emanuele Cerulli Irelli ◽  
Giuseppe Di Pietro ◽  
Giacomo Fisco ◽  
Biagio Orlando ◽  
Francesco Asci ◽  
...  
Keyword(s):  
Acute Onset ◽  
Diagnostic Assessment ◽  
Binocular Diplopia ◽  
Neurological Unit

scholarly journals Monocular Diplopia in Idiopathic Intracranial Hypertension: A Case Report and Literature Review

2021 ◽  
Author(s):  
Gianluigi R Palmieri ◽  
Mattia Sansone ◽  
Roberto De Simone ◽  
Marcello Moccia
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Acute Onset ◽  
Oculomotor Nerve ◽  
Refractive Errors ◽  
Double Vision ◽  
Single Object ◽  
Dry Eyes ◽  
Ocular Media ◽  
Binocular Diplopia

Background: Diplopia is the double vision of a single object, and can be binocular or monocular. Binocular diplopia is caused by the misalignment of the visual axes, with images falling on the fovea of the fixating eye and on the extra-foveal retina of the non-fixating eye, as a consequence of both neurological (i.e., oculomotor nerve palsies, ocular myopathies, neuromuscular junction disorders) and ophthalmic disorders (i.e., decompensation of a pre-existing strabismus). In contrast, monocular diplopia is generally explained by intraocular pathology (i.e., refractive errors, ocular media abnormalities, dry eyes), causing the image of a single object to fall, at the same time, on the fovea and on the extra-foveal retina of the same eye. Methods: We report the case of a 22-year-old woman presenting with acute-onset monocular diplopia. Results: The diagnosis of idiopathic intracranial hypertension (IIH) was based on the presence of papilloedema and elevated cerebrospinal fluid (CSF) pressure. Monocular diplopia resolved after CSF subtraction. Conclusions: We describe a case of monocular diplopia as a presenting symptom of IIH, and discuss diagnostic issues of this possibly underestimated symptom in neurology clinical practice. Careful ophthalmic and neuro-ophthalmic examination can identify clinical features of diplopia, and drive diagnosis and treatment.

Renal Infarction and Pulmonary Embolism in Patient with Myelodysplastic

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mounia Bendari ◽  
Nouama Bouanani ◽  
Mohamed Amine Khalfaoui ◽  
Maryam Ahnach ◽  
Aziza Laaraj ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Myeloproliferative Neoplasms ◽  
Bone Biopsy ◽  
Bone Marrow Aspiration ◽  
Myeloproliferative Disorders ◽  
Acute Onset ◽  
International Prognostic Scoring System ◽  
Renal Infarction ◽  
The Right ◽  
Enhanced Computed Tomography

The myelodysplastic syndrome-myeloproliferative neoplasms (MDS/MPNs) are defined by a group of heterogeneous hematological malignancies resulting from stem cell−driven clonal growth of pathological hematopoietic progenitors and ineffective hematopoiesis, they are characterized concomitant myelodysplastic and myeloproliferative signs. Myelodysplastic/myeloproliferative disorders have been considered to have a higher risk of thrombus formation.We report a rare case about a 64 years old Moroccan woman, experienced renal infarction (RI) associated with pulmonary embolism as a complication of a myelodysplastic/myeloproliferative disorder.The patient complained of acute-onset severe left flank pain, a contrast-enhanced computed tomography (CT) of the chest and abdomen revealed RI by a large wedge-shaped defect in the right kidney with pulmonary embolism.Biological exam showed deep anemia, the bone marrow aspiration found myelodysplasia.the bone biopsy showed signs of myeloproliferatif disease. The karyotype was normal, BCR-ABL, JAK2, CALR mutations were absents, and MPL mutation was positive. The International Prognostic Scoring System (IPSS-R) was 0, and the patient was included to the low risk group.Anticoagulation therapy was initiated with heparin to treat RI and pulmonary embolism. Three months later, pulmonary embolism had resolved without the appearance of additional peripheral infarction.This case emphasizes the need to consider myelodysplastic/myeloproliferative disorders as a cause of infraction renal and pulmonary embolism.

Omental Infarction: A Case Treated with Laparoscopic Surgery

2019 ◽  
pp. 1-3
Author(s):  
Bertrand Ng ◽  
Arafat Yasser
Keyword(s):  
Diabetes Mellitus ◽  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Inflammatory Markers ◽  
Acute Onset ◽  
Laparoscopy Surgery ◽  
History Of ◽  
Background History ◽  
The Right

Omental infarct is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Here, we present a case of omental infarct in a 67-year-old gentleman with background history of diabetes mellitus who present unusually with a severe acute onset right hypochondrium pain. Examination revealed that he was tender to touch at the right and was having localized guarding. His inflammatory markers were normal. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day. Omental infarct cases with right hypochondrium pain can sometimes mimicked acute cholecystitis and management includes laparoscopic surgery which can hasten symptoms resolution and reduces hospital stay, however recommendation for surgery has to be balanced with anesthetics risk and complication of the surgery itself.

Neurological Impact of Wallenberg Syndrome on the Visual-Vestibular Systems

2020 ◽  
pp. 8-14
Keyword(s):  
Case Report ◽  
Left Vertebral Artery ◽  
Clinical Correlation ◽  
Ocular Motor ◽  
Eye Care ◽  
Motor Responses ◽  
Wallenberg Syndrome ◽  
Video Recordings ◽  
Binocular Diplopia ◽  
Skew Deviation

Purpose: This case discusses the neurological impact of Wallenberg syndrome on the visual-vestibular system and provides a clinical pathologic correlation between neuro-anatomic involvements with the manifesting symptoms. Case Report: A 50-year-old male presented for consultation following a left lateral medullary infarct occlusion of the left vertebral artery (Wallenberg syndrome) with complaints of intermittent binocular diplopia, vertigo, and oscillopsia. Assessment revealed an intermittent central nystagmus, a right skew deviation, and a left Horner’s syndrome. Video recordings of the nystagmus and ocular motor responses were documented. Conclusion: Wallenberg syndrome has very defined characteristics which can be used clinically to make a definitive diagnosis.It is important for eye care professionals to understand the neuro-anatomic involvements associated with this condition and make the clinical correlation to aid in the treatment and management of these patients.

Clinical manifestations and diagnosis of keratoconus. Treatment of iatrogenic keratoconus

2020 ◽  
pp. 37-42
Author(s):  
Fedor Ermolyuk
Keyword(s):  
Research Methods ◽  
Contact Lenses ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Refractive Errors ◽  
Dry Eyes ◽  
Advanced Stages ◽  
Dystrophic Disease ◽  
Iatrogenic Origin ◽  
Binocular Diplopia

Keratoconus is a dystrophic disease of the cornea, when it is thinned with the formation of a conus-like protrusion (protrusion of the cornea). This disease belongs to the group of keratectasia, it has a multifactorial nature and occurs in approximately 25 % of all corneal pathologies. The disease can be either primary, which is based on dystrophic changes in the cornea, or secondary, which develops against the background of prenatal keratitis. Keratoconus of iatrogenic origin, which develops as a result of refractive eye microsurgery, has become widespread during the last 20 years. Most often primary keratoconus manifests during puberty, progresses to 30–40 years, after which its development slows down. An early clinical manifestation of this corneal pathology is a progressive decrease in visual acuity, development of double vision (binocular diplopia) with the development of a strong headache against this background. Monocular polyopia — images and symbols with multiple contours — develops subsequently. Severe dry eyes, itching, photophobia appear in advanced stages. Diagnosis of keratoconus in some cases can be a significant difficulty, since the use of conventional research methods only allow to suspect refractive errors in the form of myopia or astigmatism. It is necessary to take into account the impossibility of correcting visual impairment using conventional methods — glasses or contact lenses — to make correct diagnosis. As a rule, diagnosis of keratoconus requires use of expanded spectrum of instrumental research methods.

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