• Title/Summary/Keyword: optic neuritis

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Myelin oligodendrocyte glycoprotein antibody-associated disorders: clinical spectrum, diagnostic evaluation, and treatment options

  • Lee, Yun-Jin;Nam, Sang Ook;Ko, Ara;Kong, JuHyun;Byun, Shin Yun
    • Clinical and Experimental Pediatrics
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    • v.64 no.3
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    • pp.103-110
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    • 2021
  • Inflammatory or immune-mediated demyelinating central nervous system (CNS) syndromes include a broad spectrum of clinical phenotype and different overlapping diseases. Antibodies against myelin oligodendrocyte glycoprotein (MOG-Ab) have been found in some cases of these demyelinating diseases, particularly in children. MOG-Ab is associated with a wider clinical phenotype not limited to neuromyelitis optica spectrum disorder, with most patients presenting with optic neuritis, acute disseminated encephalomyelitis (ADEM) or ADEM-like encephalitis with brain demyelinating lesions, and/or myelitis. Using specific cell-based assays, MOG-Ab is becoming a potential biomarker of inflammatory demyelinating disorders of the CNS. A humoral immune reaction against MOG was recently found in monophasic diseases and recurrent/multiphasic clinical progression, particularly in pediatric patients. This review summarizes the data regarding MOG-Ab as an impending biological marker for discriminating between these diverse demyelinating CNS diseases and discusses recent developments, clinical applications, and findings regarding the immunopathogenesis of MOG-Ab-associated disorders.

Relapse of Multiple Sclerosis with Isolated Upbeat Nystagmus (단독 상방 안진으로 재발한 다발성 경화증)

  • Lim, Eui-Seong;Shin, Byoung-Soo
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.179-181
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    • 2006
  • Multiple sclerosis is an autoimmune demyelinating disorder of the nervous system. The ocular manifestation includes optic neuritis, internuclear opthalmoplegia and nystagmus. Upbeat nystagmus is a rare manifestation of multiple sclerosis. We report a patient with relapsing multiple sclerosis who presented with upbeat nystagmus from a circumscribed lesion in the caudal medulla.

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Bilateral Optic Neuritis after Measles Infection (홍역 감염 후 발생한 양측성 시신경염 1례)

  • Hwang, Sung Hyun;Kim, Jong-Hyun;Oh, Jin Hee;Koh, Dae Kyun
    • Pediatric Infection and Vaccine
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    • v.11 no.2
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    • pp.192-197
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    • 2004
  • A 9-year-old boy who was confirmed measles by clinical manifestations and serum measles IgM antibody presented with bilateral visual loss 12 days after the onset of maculopapular rash. Complete ophthalmic and neurologic examinations, radiologic studies, and lumbar puncture were performed. Visual acuities were counting fingers in both eyes, with mild bilateral optic disk hyperemia and swelling noted. Neurologic examination was unremarkable, however, a magnetic resonance imaging of the brain showed high signals on basal ganglia, and periventricular white matter. The cerebrospinal fluid was devoid of white cells. Intravenous methylprednisolone and high dose immunoglobulins were administered, and clinical findings resolved completely within 6 months.

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Hydrocephalus as a Presenting Manifestation of Neurosarcoidosis : Easy to Misdiagnose as Tuberculosis

  • Lee, Chang-Hyun;Jung, Young-Sub;Lee, Sang-Hyung
    • Journal of Korean Neurosurgical Society
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    • v.48 no.1
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    • pp.79-81
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    • 2010
  • We present a case of hydrocephalus as the primary manifestation of neurosarcoidosis. Sarcoidosis is a rare disease in Korea and its incidence is much lower than that of tuberculosis. Diagnosis is made by pathologic findings and by exclusion of other granulomatous disorders. Neurosarcoidosis is observed in approximately 5% of sarcoidosis. Its common manifestations are facial palsy (50% of patients with neurosarcoidosis) and optic neuritis. Hydrocephalus is a very uncommon reported finding. Although the typical presentation of sarcoidosis such as facial palsy is not a diagnostic dilemma, more atypical presentations such as hydrocephalus with altered mentality in a tuberculosis patient can lead to a misdiagnosis.

A case of childhood relapsing/remitting multiple sclerosis and interferon β-1b treatment in a Korean patient (소아 재발/완화형 다발성 경화증 환자에서 인터페론 베타 1b 치료 1례)

  • Kim, Hyun Seok;Lee, Won Deok;Lee, Jun Hwa;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.580-584
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    • 2007
  • Multiple sclerosis (MS) is a demyelinating disorder that affects discrete areas of the CNS, including the optic nerves, in a quite variable relapsing-remitting fashion over a prolonged period of time. Although MS is usually considered to be a disease that affects peoples in early to middle adulthood, children do develop multiple sclerosis. The frequency of MS onset before the age of 15 years is 2.7-5% of all cases, while MS onset during infancy and early childhood was observed to be 0.2-0.7% of all cases. We report here on a Korean case of a relapsing-remitting MS female child who was treated with four rounds of intravenous methylpredinsolone pulse therapy and preventive Interferon-$\beta$-1b ($Betaferon^{(R)}$).

A Case Report on a Neuromyelitis Optica Patient with Painful Tonic Spasm and Decreased Motor Function Improved by Korean Medicine Treatment Including Dokwhalgisaeng-tang (시신경척수염으로 인한 통증긴장연축과 하지 운동기능 저하를 호전시킨 독활기생탕을 포함한 한의치료 증례 보고 1례)

  • Kim, Du-ri;Yun, Jong-min
    • The Journal of Internal Korean Medicine
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    • v.39 no.2
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    • pp.130-138
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    • 2018
  • Neuromyelitis optica (NMO) is an autoimmune inflammatory disorder of the central nervous system characterized by optic neuritis and longitudinally extensive myelitis. Painful tonic spasm is a common complication of NMO, but there have been no reports about it in Korean medicine studies. In this case, we treated a 53-year-old woman diagnosed with NMO with paraplegia, painful tonic spasm, and decreased visual acuity using Korean medicine treatment, including acupuncture, herbal medicine, cupping, and moxibustion. We measured changes in clinical symptoms using the manual muscle testing (MMT), the numeric rating scale (NRS), the modified Barthel Index (MBI), and the Functional Independence Measure (FIM). After treatment, clinical symptoms were improved. The results indicate that Korean medicine treatment may be effective in the treatment of an NMO patient with paraplegia and painful tonic spasm.

Central serous chorioretinopathy associated with low dose systemic corticosteroid treatment of Behcet's disease (베체트병 환자에서 저용량 스테로이드 사용과 관련하여 발생한 중심성장액맥락망막병증)

  • Cha, Sungwook;Kim, Kyung Jin;Kweon, Seongmin;Lee, Sinae;Min, Byungchul;Kim, Eunsung;Lee, Jungwook
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.111-114
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    • 2017
  • Central serous chorioretinopathy may induce poor eyesight and serous retinal detachment. However, its exact cause has not been well established thus far. It can be associated with systemic high-dose corticosteroid treatment mainly for young and middle-aged men and may spontaneously regress or recur after withdrawal from corticosteroid. After corticosteroid administration for Behcet's disease, it is necessary to identify any ocular symptoms. Behcet's disease can lead to the development of ocular complications, such as uveitis, hypopyon, retinal vasculitis, optic neuritis, angiogenesis, secondary cataract, and glaucoma. It is possible to diagnose any of these complications via optical coherence tomography and digital indocyanine green angiography. It is easy to neglect an ocular symptom that may appear after a low-dose corticosteroid treatment as an ocular complication in patients with Behcet's disease. Thus, we report on a case concerning high-dose corticosteroid treatment with a literature review.

Screening of Workers with Presumed Occupational Methanol Poisoning: The Applicablility of a National Active Occupational Disease Surveillance System

  • Eom, Huisu;Lee, Jihye;Kim, Eun-A
    • Safety and Health at Work
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    • v.10 no.3
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    • pp.265-274
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    • 2019
  • Background: Methyl alcohol poisoning in mobile phone-manufacturing factories during 2015-2016 was caused by methyl alcohol use for cleaning in computerized numerical control (CNC) processes. To determine whether there were health complications in other workers involved in similar processes, the Occupational Safety and Health Research Institute conducted a survey. Methods: We established a national active surveillance system by collaborating with the Ministry of Employment and Labor and National Health Insurance Service. Employment and national health insurance data were used. Overall, 12,048 employees of major domestic mobile phone companies and CNC process dispatch workers were surveyed from 2016 to 2017. We investigated methyl alcohol poisoning by using the national health insurance data. Questionnaires were used to investigate diseases due to methyl alcohol poisoning. Results: Overall, 24.9% of dispatched workers were employed in at least five companies, and 23.9% of dispatched workers had missing employment insurance history data. The prevalence of blindness including visual impairment, optic neuritis, visual disturbances, and alcohol toxicity in the study participants was higher than that reported in the national health insurance database (0.02%, 0.07%, 0.23%, and 0.03% versus 0.01%, 0.07%, 0.13%, and 0.01%, respectively, in 2015). Moreover, 430 suspicious workers were identified; 415 of these provided an address and phone number, of whom 48 responded (response rate, 11.6%). Among the 48 workers, 10 had diseases at the time of the survey, of whom 3 workers were believed to have diseases related to methyl alcohol exposure. Conclusion: This study revealed that active surveillance data can be used to assess health problems related to methyl alcohol poisoning in CNC processes and dispatch workers.

Visual Disturbance following Autologous Fat Injection into Periorbital Area (안와부 자가지방이식술 후 시력 저하에 대한 증례보고)

  • Jeon, Young Woo;Kim, Sung Soo;Ha, Sang Wook;Lee, Young Dae;Seul, Chul Hwan;Tark, Kwan Chul;Cho, Eul Jae;Yoo, Won Min
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.663-666
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    • 2007
  • Purpose: Autologous fat injection into the facial area is a frequently used technique in aesthetic plastic surgery for augmentation of the soft tissue. Fat injection is a very safe procedure because of the advantage of being autologous tissue. Minimal foreign body reaction or infections are noted after fat injection. However, there may be some complications including those as severe as blindness. There have been some case reports on visual disturbances after autologous fat injection reported in the literature. Methods: A 21-year-old female patient underwent autologous fat injection into left eyebrow area to correct depression of soft tissue. Immediately after injection of autologous fat, she complained sudden visual loss on the left eye. She had come to our emergency room and ophthalmologic evaluation showed that the patient could only recognize hand motion. There was no abnormality of the optic nerve on magnetic resonance imaging. Suspecting an ischemic optic neuritis from fat embolism of the central retinal artery, the patient was treated conservatively with occular massage, antiglaucomatic agent, anti-inflammatory drugs and antibiotics. Visual field examination showed visual defect of half the lower hemisphere. Results: While maintaining antiglaucomatic agents and non steroidal anti inflammatory drugs, fundoscopic examination showed no abnormalities on the second day of admission. Visual field examination showed an improvement on the fourth day along with decreased eyeball pain. Significant improvement of vision was noted and the patient was discharged on the fifth day of admission. The patient was followed-up 2 days afterwards with improved vision and visual field defect. Conclusion: We describe an unusual case of sudden unilateral visual disturbance following autologous fat injection into periorbital area.