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18 Cards in this Set
- Front
- Back
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What is the difference between a sphenocavernous syndrome and an orbital apex lesion?
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Spheno has painful ophthalmoplegia and pt. has normal VA and no protopsis(eye comes out of orbit)
Orbital apex lesion causes ophthalmoplegia that may or may not be painful. Assoc. with vision loss and protopsis. |
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What are some non-ocular symptoms of cavernous sinus thrombosis that precedes ocular involvement?
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Periorbital edema and chemosis
proptosis increased IOP ophthalmoplegia involving CN 3,4,or 6 Spread of infection to other eye** |
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How do you treat Cavernous Sinus Thrombosis?
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1. broad spectrum AB
2. Heparin (anticoagulation) to prevent further thrombosis/emboli 3. corticosteroids reduce inflammation and edema 4. Drainage of infection |
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What is the prognosis of cavernous sinus thrombosis?
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Death w/o tx
with aggressive tx 30% mortality 50% have residual nerve damge. 25% have visual impairment |
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What are the clinical features of a Carotid-cavernous fistula anterior drainage?
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1. Corkscrew conjunctival veins
2. Proptosis 3. orbital bruit 4. increased IOP 5. dilated retinal veins 6. Extraocular muscle paresis. anterior drainage=red eye |
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What are the clinical features of a Carotid-cavernous fistula posterior drainage?
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white eye. ocular motor nerve palsy
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What is the treatment for carotid cavernous fistula?
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for indirect no treatment is required.
For direct: neuro-endovascular surgery to block flow through fistula. |
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What are the clinical features of tolosa hunt syndrome?
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severe, steady, retro-orbital/periorbital pain +diplopia.
Involvment of optic nerve and trigeminal nerve Pupil dilated if parasympathetics are involved constricted if sympathetics are involved |
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How do you treat tolosa hunt?
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corticosteroids
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Prognosis of tolosa hunt
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relapse 30-40%
Beware of tumors |
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What are some causes of guillain-barre syndrome?
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URI or GII from C. jejuni.
Vaccination, surgery, and meds like lithium. |
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What are some clinical features of Guillain-Barre syndrome?
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Progressive motor weakness in more then one limb.
Areflexia ptosis ophthalmoplegia dilated non-reactive pupil accomodation paralysis optic neuritis papilledema |
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what are the 4 Neuropathies Causing Ophthalmoplegia?
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1. Guillain-Barre Syndrome
2. Miller-Fisher Syndrome 3. Abetalipoproteinemia 4. Refsum Disease |
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What is the classic Miller-Fisher triad ?
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Ophthalmoplegia(upgaze first, the horizontal and downgaze)
Ataxia Areflexia |
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What AB do you check for to diagnose miller fisher syndrome?
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IgG anti-GQ1b ganglioside antibodies
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What is abetalipoproteinemia?
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malabsorption of fat-soluble vitamins A, D, E, and K.
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What are the clinical findings of abetalipoproteinemia?
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Steatorrhea (fatty stool)
Cerebellar ataxia areflexia loss of proprioception pigmentary retinopathy ophthalmo. and ptosis slow saccades and more |
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What is Refsum's disease?
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very rare! caused by phytanic acid metabolism defect.
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