scholarly journals Optic Neuritis in Pediatric Patients

2021 ◽  
Vol 8 (2) ◽  
pp. 102
Author(s):  
Atik Rahmawati ◽  
Dina Fatmawati
Keyword(s):  
Body Weight ◽  
Optic Nerve ◽  
Physical Examination ◽  
Optic Neuritis ◽  
Pediatric Patients ◽  
Vision Loss ◽  
Case Series ◽  
Atypical Symptoms ◽  
Ophthalmologic Examination ◽  
Symptoms And Signs

Optic neuritis denotes an inflammation of the optic nerve characterized by loss of vision progressing over a few hours to a few days. Based on the site involved, optic neuritis is classified as retrobulbar (2/3 cases), atypical, and typical optic neuritis. In some cases, pediatric patients with optic neuritis have atypical symptoms and signs and no comprehensive medical history leading to a challenging diagnosis. In this case series, we report cases of optic neuritis in pediatric patients at different ages and clinical features treated with methylprednisolone 1 mg/kg body weight and oral mecobalamin and respective management. With a poor initial vision at presentation, the patients recovered rapidly.  The diagno-sis of optic neuritis was based on anamnesis, ophthalmologic examination, and simple laboratory and physical examination. The administration of steroids at a dose of 1 mg/kg body weight followed by a taper of dose can improve vision loss.

Management of Optic Neuritis in Ayurveda - A Special Case Report

2018 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Harsha S. ◽  
Dr. Mamatha KV.
Keyword(s):  
Optic Nerve ◽  
Optic Neuritis ◽  
Visual Information ◽  
Vision Loss ◽  
Specific Treatment ◽  
Interesting Case ◽  
Treatment Modalities ◽  
Further Development ◽  
Special Case

The optic nerve carries visual information from your eye to your brain. Optic neuritis is when your optic nerve becomes inflamed. Optic neuritis can flare up suddenly from an infection or nerve disease. The inflammation usually causes temporary vision loss that typically happens in only one eye. Those with Optic neuritis sometimes experience pain. As you recover and the inflammation goes away, your vision will likely return. There are no direct references in our classics regarding optic neuritis but can be contemplated as a condition by name Parimlayi Timira. The specific management as such is not cited but a transcendence approach can be done with adopting the treatment which has the ability to pacify the already occurred pathology and prevent the further development of the disease. One such interesting case study on Optic neuritis is elaborated here where in specific treatment modalities (Shodana, Shamana and Kriyakalpas) played role in pacifying the condition.

scholarly journals Atypical presentation of testicular torsion: a case series

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Uzodimma Ejike Onwuasoanya
Keyword(s):  
Physical Examination ◽  
Testicular Torsion ◽  
Age Groups ◽  
Case Series ◽  
Atypical Presentation ◽  
Testicular Pain ◽  
Future Fertility ◽  
Urological Emergency ◽  
High Index Of Suspicion ◽  
Symptoms And Signs

Abstract Background Testicular torsion is a urological emergency and needs urgent intervention to prevent testicular loss and impaired future fertility. It is commonly seen in the neonatal and adolescent age groups. Testicular torsion can also present outside these common age groups with uncommon symptoms and signs. We report case series of patients managed at Lily Hospitals Limited, Warri, Delta State, Nigeria with atypical presentation of testicular torsion. Case Presentation The first patient was a 35-year-old male that presented with recurrent right testicular pain of 1-year duration, described as dull aching with no constitutional symptoms, physical examination findings were not pathognomonic of testicular torsion, he had scrotal exploration with right orchidectomy and left orchidopexy. The second patient was a 39-year-old male who presented with recurrent right testicular pain of 4-days duration, described as dull aching with no constitutional symptoms. Physical examination findings were not classical for testicular torsion, he had scrotal exploration with bilateral orchidopexy. Conclusion Testicular torsion although common in neonatal and adolescent age groups can also present outside these age groups with uncommon symptoms and signs, a high index of suspicion is thus invaluable in any patient presenting with testicular pain despite the age and severity to avoid missing the diagnosis as this can lead to testicular loss.

scholarly journals Acute disseminated encephalomyelitis followed by recurrent or monophasic optic neuritis in pediatric patients

2012 ◽  
Vol 19 (7) ◽  
pp. 941-946 ◽  
Author(s):  
Peter Huppke ◽  
Kevin Rostasy ◽  
Michael Karenfort ◽  
Brenda Huppke ◽  
Rainer Seidl ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Optic Neuritis ◽  
Pediatric Patients ◽  
Case Series ◽  
Acute Disseminated Encephalomyelitis ◽  
Oligoclonal Bands ◽  
Central Nervous System Disorders ◽  
Established Disease

Background: Some pediatric patients with inflammatory demyelinating central nervous system disorders cannot be classified under any of the established disease entities, making their treatment and prognosis difficult. Objective: The objective of this study is to characterize a subgroup of pediatric patients with recurrent demyelinating central nervous system disorders. Methods: This study includes a case series of pediatric patients with monophasic or recurrent acute disseminated encephalomyelitis (ADEM) who later presented with either monophasic or recurrent optic neuritis (ON). Results: We describe seven patients with a median follow-up of six years (five females, two males) who presented at a median age of 6 years (range 4–8 years) with monophasic ( n = 4) or recurrent ADEM (two to four attacks) followed by monophasic ( n = 3) or recurrent ON (two to nine attacks). Cranial magnetic resonance imaging (MRI) was typical for ADEM ( n = 6) with complete or almost complete resolution of lesions on follow-up. Cerebrospinal (CSF) studies at the time of ADEM showed a pleocytosis in six patients and were negative for oligoclonal bands (OCBs) in all. In all patients high titers for serum anti-MOG antibodies were detected. Conclusion: ADEM followed by ON is a rare but distinct clinical phenotype among pediatric patients. Further studies are needed to allow recommendations on treatment or prognosis.

scholarly journals Pediatric Idiopathic Intracranial Hypertension: A not so Rare and Benign Condition

2014 ◽  
Vol 7 (1) ◽  
pp. 5-9
Author(s):  
Manish Modi ◽  
Karan Gupta
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Vision Loss ◽  
Fluid Pressure ◽  
Case Series ◽  
Invasive Procedure ◽  
Positive Outcome ◽  
Benign Condition ◽  
Work Up

ABSTRACT Objective Pediatric idiopathic intracranial hypertension is an underdiagnosed entity with catastrophic presentations. High index of suspicion with early diagnosis and prompt treatment is the key to successful management. Trans-nasal trans-sphenoid Endoscopic Optic Nerve Fenestration is an effective surgical modality for the reversal of vision loss in pediatric idiopathic intracranial hypertension (IIH). Materials and methods This is a single center observational prospective case series. Five diagnosed pediatric patients of IIH satisfying the modified Dandy criteria and reported to the out-patient services of otolaryngology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India in the year 2012 were included in this study. All children underwent thorough clinical examination, complete Neuro-ophthalmological work-up including Visual acuity (V/A), Visual field charting (V/F), Fundus venogram and Radiological work-up with MRI for special optic nerve sections in sagittal reconstruction. Cerebro-Spinal Fluid pressure (CSF) measured preoperatively for all children. Standard endoscopic optic nerve Sheath Fenestration was performed on all children. visual improvement was assessed by comparing preoperative ophthalmological findings. Results Improvement in vision was taken as a positive outcome. Vision improved in all except one child, who had pre-existing optic nerve atrophy. Conclusion Endoscopic optic nerve fenestration is an effective minimally invasive procedure to revert visual loss in pediatric idiopathic intracranial hypertension. How to cite this article Gupta AK, Gupta K, Modi M, Gupta A. Pediatric Idiopathic Intracranial Hypertension: A not so Rare and Benign Condition. Clin Rhinol An Int J 2014;7(1):5-9.

scholarly journals Influence of retrobulbar neuritis and papillitis on echographically measured optic nerve diameter

2010 ◽  
Vol 67 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Ivan Stefanovic ◽  
Milos Jovanovic ◽  
Bojana Dacic-Krnjaja ◽  
Dragan Veselinovic ◽  
Predrag Jovanovic
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Neuritis ◽  
Significant Negative Correlation ◽  
Optic Disk ◽  
Partial Loss ◽  
Retrobulbar Neuritis ◽  
Optic Nerve Diameter ◽  
Ophthalmologic Examination ◽  
Retrobulbar Optic Neuritis

Background/Aim. Retrobulbar (optic) neuritis is inflammation of the optic nerve that may cause a complete or partial loss of vision. This inflammation can affect a part of the nerve within the eyeball (neuropapillitis) or a part of the nerve behind the eyeball (retrobulbar neuritis). The aim of this study was to establish whether there is a correlation between the diameter of a retrobulbar part of the optic nerve and either visual acuity, prominence of the optic disk (papillitis), or nature of the neuritis (papillitis or retrobulbar). Methods. We tested 23 patients with retrobulbar neuritis and papillitis. In addition to a complete ophthalmologic examination, the diameter of retrobulbar region of the optic nerve was measured by the B-scan method. Following this, the 30-degree test was carried out. Results. We found an increased thickness of the retrobulbar region in 22 patients and different responses to the 30-degree test, as well as a statistically significant negative correlation between the thickness of retrobulbar part of the optic nerve and visual acuity. Conclusion. The retrobulbar part of the optic nerve is thicker in 94% of the patients with retrobulbar neuritis and in all the patients with papillitis. There is a correlation between the reduction of visual acuity and thickening of a retrobulbar part.

scholarly journals Optic Nerve Sheath Meningioma Masquerading as Optic Neuritis

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
R. Alroughani ◽  
R. Behbehani
Keyword(s):  
Optic Nerve ◽  
Optic Neuritis ◽  
Vision Loss ◽  
Imaging Modality ◽  
White Matter Lesions ◽  
Optic Nerve Sheath ◽  
Common Presentation ◽  
Nerve Sheath ◽  
Optic Nerve Sheath Meningioma ◽  
Demyelinating Disorders

Optic neuritis is a common presentation of demyelinating disorders such as multiple sclerosis. It typically presents with acute painful monocular vision loss, whereas chronic optic neuropathy can be caused by compressive lesions along the anterior visual pathway, genetic, toxic, or nutritional causes. We report an unusual presentation mimicking optic neuritis, which was subsequently diagnosed as optic nerve sheath meningioma (ONSM). Misinterpretation of white matter lesions on MRI of brain and the failure to image the optic nerves at the time of acute loss of vision led to the misdiagnosis of optic neuritis in this case. A comprehensive accurate history and ordering the appropriate imaging modality remain paramount in diagnosing progressive visual deterioration.

Pediatric Fluid and Electrolyte Therapy

1989 ◽  
Vol 2 (1) ◽  
pp. 55-59
Author(s):  
Lisa S. Lifshin
Keyword(s):  
Body Weight ◽  
Physical Examination ◽  
Pediatric Patients ◽  
Fluid Replacement ◽  
Patient History ◽  
Maintenance Fluid ◽  
Disease States ◽  
Maintenance Fluid Therapy ◽  
Adequate Method ◽  
In Infants And Children

Fluid and electrolyte therapies in pediatric patients are reviewed. Physiologically, the proportion of body water to body weight is different in infants and children than adults. This difference makes managing the pediatric patient an intricate task. Several factors that may increase or decrease fluid needs are discussed. The main goals of deficit/replacement and maintenance therapies are reviewed. Laboratory analyses assist in evaluating the types of dehydration states. The degree of dehydration may be established by patient history and physical examination. The 5%, 10%, and 15% rule of dehydration is an adequate method for estimating proper fluid replacement. Maintenance fluid therapy is evaluated and described for certain pediatric disease states, such as pyloric stenosis, burns, and surgery. Guidelines are presented for each situation, but each patient should be treated on an individual basis.

scholarly journals Targeting Oxidative Stress for Treatment of Glaucoma and Optic Neuritis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Atsuko Kimura ◽  
Kazuhiko Namekata ◽  
Xiaoli Guo ◽  
Takahiko Noro ◽  
Chikako Harada ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Optic Nerve ◽  
Optic Neuritis ◽  
Vision Loss ◽  
Demyelinating Disease ◽  
Ganglion Cells ◽  
Retinal Ganglion ◽  
Progressive Degeneration ◽  
Elevated Intraocular Pressure ◽  
The Central Nervous System

Glaucoma is a neurodegenerative disease of the eye and it is one of the leading causes of blindness. Glaucoma is characterized by progressive degeneration of retinal ganglion cells (RGCs) and their axons, namely, the optic nerve, usually associated with elevated intraocular pressure (IOP). Current glaucoma therapies target reduction of IOP, but since RGC death is the cause of irreversible vision loss, neuroprotection may be an effective strategy for glaucoma treatment. One of the risk factors for glaucoma is increased oxidative stress, and drugs with antioxidative properties including valproic acid and spermidine, as well as inhibition of apoptosis signal-regulating kinase 1, an enzyme that is involved in oxidative stress, have been reported to prevent glaucomatous retinal degeneration in mouse models of glaucoma. Optic neuritis is a demyelinating inflammation of the optic nerve that presents with visual impairment and it is commonly associated with multiple sclerosis, a chronic demyelinating disease of the central nervous system. Although steroids are commonly used for treatment of optic neuritis, reduction of oxidative stress by approaches such as gene therapy is effective in ameliorating optic nerve demyelination in preclinical studies. In this review, we discuss oxidative stress as a therapeutic target for glaucoma and optic neuritis.

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Optic Neuritis in Canada

2020 ◽  
pp. 1-6
Author(s):  
Anubhav Garg ◽  
Edward Margolin ◽  
Jonathan A. Micieli
Keyword(s):  
Optic Neuritis ◽  
Clinical Characteristics ◽  
Vision Loss ◽  
Brain Mri ◽  
Visual Fields ◽  
Case Series ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Mean Deviation ◽  
High Dose ◽  
Rnfl Thickness

ABSTRACT: Objective: To describe clinical characteristics of Canadian patients with myelin-oligodendrocyte glycoprotein immunoglobulin-G optic neuritis (MOG-IgG ON). Methods: Retrospective observational case series of MOG-IgG seropositive patients with ON referred to tertiary neuro-ophthalmology practices. Outcome measures included clinical characteristics, radiologic findings, and visual outcomes. Results: Forty-six eyes of 30 patients were included. Twenty-three (76.7%) were women, mean onset age was 40.7 years (range 16–77), and most were Caucasian. Seventeen (56.7%) presented with their first ON episode. Sixteen (53.3%) had bilateral eye involvement. Isolated ON without associated neurological symptoms occurred in 90.0%. In 22 patients with acute ON (seen within 1 month of onset), presenting mean visual acuity (VA) was 20/258 (logMAR 1.11), mean deviation (MD) on Humphrey visual fields was −16.90 ± 10.83 dB, and peripapillary retinal nerve fiber layer (RNFL) thickness on ocular coherence tomography (OCT) was 164.23 ± 46.53 um. Orbital magnetic resonance imaging (MRI) within 1 month of symptom onset for 19 patients demonstrated orbital optic nerve enhancement in 11 (57.9%) and perineural enhancement in 11 (57.9%). Brain MRI was normal in 28 (93.3%) patients. Twenty out of 22 patients with acute presentation were treated with high-dose glucocorticoids and 5 with plasma exchange in addition to corticosteroids. Long-term immunosuppression was utilized in 9 (30%) out of all 30 patients. Final VA was 20/30 (logMAR 0.18), MD was −7.17 ± 8.85 dB, and RNFL thickness was 72.15 ± 20.16 um. Conclusion: MOG-IgG ON in Canada has a variable presentation with most patients having substantial initial vision loss with good recovery. This is the largest characterization of the disease in Canada to date.

Vision salvage after resection of a giant meningioma in a patient with a loss in light perception

2009 ◽  
Vol 110 (1) ◽  
pp. 109-111 ◽  
Author(s):  
Michael E. Sughrue ◽  
Michael W. McDermott ◽  
Andrew T. Parsa
Keyword(s):  
Optic Nerve ◽  
Vision Loss ◽  
Case Series ◽  
Optic Chiasm ◽  
Surgical Removal ◽  
Compression Stress ◽  
Light Perception ◽  
Nerve Dysfunction ◽  
Mass Lesions ◽  
Giant Meningioma

Clinical approaches to the surgical management of optic chiasm compression stress quick action, as several case series have demonstrated minimal vision restoration following aggressive decompression in patients presenting more than 3 days after the onset of blindness. The authors here report the case of a 48-year-old woman who presented with near-complete binocular vision loss but regained visual function following surgical removal of a giant planum-tuberculum meningioma, which was performed 8 days after a documented loss in light perception. The interval between the patient's vision loss and successful vision-restoring decompressive surgery is the longest recorded to date in the literature. This case shows the importance of aggressive decompression of mass lesions despite extended intervals of optic nerve dysfunction.

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