Giant-cell arteritis with bilateral uveitic glaucoma.
Bilateral uveitic glaucoma occurred in a patient with giant-cell arteritis. The mechanism appeared to be immunologic, not ischemic.
Biomedical subjects
Publications and source records attributed to M L Monteiro.
Bilateral uveitic glaucoma occurred in a patient with giant-cell arteritis. The mechanism appeared to be immunologic, not ischemic.
An analysis of two new cases and four previously reported cases produced evidence for a syndrome of arterial-occlusive retinopathy and encephalopathy. All six patients were women; they ranged in age from 21 to 40 years. The clinical features of this condition include multiple branch retinal arterial occlusions and encephalopathy in which behavioral and memory disturbances predominate early. Hearing loss is frequent. Except for cerebrospinal fluid pleocytosis and an increased cerebrospinal fluid protein level, there are few laboratory or radiographic abnormalities. The disease may be responsive to corticosteroid therapy. There are some similarities between this syndrome and systemic lupus erythematosus but it appears to be a distinct disease entity. A comparison of the retinal findings with those described in experimental allergic encephalitis suggests that this may be a virally induced immune-mediated disease. Although only four clearly documented examples of this syndrome have been reported, we suspect that cases may have been overlooked because of failure to recognize arterial branch occlusions in the peripheral retina.
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Two patients had truncal ataxia, upbeat nystagmus, and upgaze palsy. Initially, a paraneoplastic disorder was suspected, but a temporal artery biopsy revealed giant cell arteritis (GCA). This unusual clinical manifestation of GCA probably resulted from thromboembolic complications of vertebral arteritis.
Report of a case with craniofacial dysmorphism and opsoclonus. The opsoclonus commenced in the perinatal period and abated at 18 months. Previous cases of opsoclonus associated with cranial and facial anomalies are reviewed, and it is suggested that opsoclonus in the authors' case was related to the delayed maturation of inhibitory cells in the brainstem.
A 67-year-old woman had acutely diminished vision and painful proptosis of the left eye amidst a background of chronic headache, scalp tenderness, proximal myalgias, intermittent fever, anemia, and elevated erythrocyte sedimentation rates. All symptoms and signs were exquisitely corticosteroid-responsive. She underwent two negative temporal artery biopsies and several extensive negative evaluations for systemic disease. Ultimately deep scalp biopsy, bone biopsy, and bone marrow aspiration were performed, and all revealed a histologically well-differentiated lymphoma.
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We report herein the unique finding of a small perimesencephalic vascular anomaly in a patient with a partial oculomotor nerve palsy and a 25-year history of recurrent ophthalmoplegic migraine.
Downbeat nystagmus developed in a 67-year-old hypomagnesemic woman while she was receiving lithium carbonate for depression. This nystagmus abated each time lithium carbonate therapy was withdrawn, and no alternative causes of nystagmus were demonstrated. However, this nystagmus occurred despite serum lithium carbonate levels in the nontoxic range. Total-body magnesium deficiency may have enhanced the toxic effect of lithium carbonate on cerebellomedullary connections.
The first case of typical Foster-Kennedy syndrome, including decreased olfaction of the side of the optic atrophy due to a primary solitary intracranial extraskeletal plasmacytoma, is reported. Its appearance on a computed tomography scan was compatible with a meningioma or subdural hematoma. The patient demonstrated a chronic, corticosteroid-sensitive, relapsing optic neuropathy associated with an elevated sedimentation rate and a monoclonal gammopathy. The diagnosis, treatment, and prognosis of such tumors are reviewed.
A 25 year old with vitiligo por 6 years now. For one year has being presenting hyperthyroidism, myasthenia gravis and periodic paralysis. The normalization of the thyroid function was followed by a significant improvement of the myasthenic syndrome that did not interfere with the paralytical attacks.
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An unusual case of a young woman, heterozygote for Fabry gene is reported, who presented bilateral thalamic infarcts due to occlusions of central nervous system vessels. Three other members of her family were studied. Fabry's disease (angiokeratoma corporis diffusum) is included among the rare causes of ischemic stroke in young adults.