Neuro-Ophthalmic Literature Review

Neuro-Ophthalmic Literature Review Panitha Jindahra, Axel Petzold, Evan Price, John H. Pula, Michael Vaphiades, and Sui Wong INTRACTABLE VOMITING IN NMO Yeo LL, Wieder N, Wang AS, Ting E, Rathakrishnan R, Soon D. Pearls & Oy-sters: a cause of intractable vomiting. Neurology 2014;83:e141–e144. The authors reported a patient with optic neuritis who initially presented with intractable vomiting, dysphagia, and left hypoglossal nerve palsy. The symptoms subsided with intravenous methylprednisolone. Serum neuromyelitis optica immunoglobulin G (NMO-IgG) was positive, confirming a diagnosis of NMO. Brain magnetic resonance imaging (MRI) showed abnormal signal in the dorsal medulla and area postrema. The area postrema, a vomiting centre, is rich in aquaporin-4 and one of the antibody targets. Panitha Jindahra RETINOPATHY IN ACUTE AORTIC DISSECTION Arao K, Kuribara A, Jinnouchi H, Matsumoto M, Fujiwara T, Kinoshita N, Kakehashi A, Ako J, Momomura S. Transient retinopathy in acute aortic dissection. Ophthalmology 2014;121:2261–2267. This is a propective observational study of 64 patients with Stanford type B acute aortic dissection. Retinopathy was demonstrated in 55% of cases in the acute phase and resolved subsequently within 2 to 3 months following conservative treatment. Retinopathy findings included cotton wool spots alone (n = 31), dot haemorrhages alone (n = 1), and both (n = 3). Cases with retinopathy experienced more cardio-cerebrovascular events than those without. In addition, cases with retinopathy were associated with a history of hypertension and high peak C-reactive protein levels. Panitha Jindahra SEESAW DYSAUTONOMIA Wu H, Ahmed K, Tan K, Blair NF. Seesaw dysautonomia: a manifestation of autonomic dysreflexia. Neurology 2014;83:2093–2095. The authors reported a 58-year-old man who presented with several episodes of alternating anisocoria, unilateral hyperhidrosis ipsilateral to the larger pupil, and hypertension. These episodes occurred after an incomplete spinal cord injury at the level of C6–C7 many years past. Anisocoria seen in this case could be due to sympathetic overactivity of autonomic dysreflexia on one side with contralateral suppression on the other. Panitha Jindahra