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Visual Symptoms (visual + symptom)
Selected AbstractsExpert Opinion: Retinal Migraine: Migraine Associated With Monocular Visual Symptoms (CME)HEADACHE, Issue 1 2008Randolph W. Evans MD First page of article [source] 3164: Post-concussive syndromeACTA OPHTHALMOLOGICA, Issue 2010V PURVIN Purpose Over 85% of traumatic brain injuries (TBI) are considered "mild", also referred to as "concussion". Mild TBI is increasingly recognized as an important public health problem. Despite their designation as "mild", adverse outcomes from such injuries are significant, with 25% of patients still impaired at one year. Visual difficulties are common, reported by two-thirds of patients in a Veterans Administration study. Methods Visual symptoms of mild TBI typically include blurring, light sensitivity, eyestrain, difficulty with near focus, trouble tracking, seeing haloes around lights, and diplopia (monocular and binocular). Results Despite the high incidence of visual symptoms, results of standard eye examination and neuro-ophthalmic testing are typically normal. Conventional neuro-imaging also fails to demonstrate objective evidence of neurologic dysfunction in most cases. Recent developments in neuroimaging (particularly diffusion tensor imaging) and serologic testing (S-100B) have provided some correlates of such injury. Conclusion New information from neuroimaging and serologic testing has helped to provide some objective markers for post-concussive syndromes. The diagnosis of such post-traumatic syndromes remains largely clinical. [source] Seizures and paroxysmal events: symptoms pointing to the diagnosis of pyridoxine-dependent epilepsy and pyridoxine phosphate oxidase deficiencyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2010BERNHARD SCHMITT Aim, We report on seizures, paroxysmal events, and electroencephalogram (EEG) findings in four female infants with pyridoxine-dependent epilepsy (PDE) and in one female with pyridoxine phosphate oxidase deficiency (PNPO). Method, Videos and EEGs were analysed and compared with videos of seizures and paroxysmal events archived from 140 neonates. PDE and PNPO were proven by complete control of seizures once pyridoxine or pyridoxal 5,-phosphate was administered and by recurrence when withdrawn. Mutations in the antiquitin gene were found in three patients and in the PNPO gene in one child. Results, Seizures began within 48 hours after birth in four newborns and at age 3 weeks in one. Frequent multifocal and generalized myoclonic jerks, often intermixed with tonic symptoms, abnormal eye movement, grimacing, or irritability, were observed in all infants with PDE and PNPO, but rarely in the other archived videos of neonates. EEGs were inconstant and frequently no discernable ictal changes were recorded during the seizures and the paroxysmal events. In addition, interictal EEGs were inconclusive, with normal and abnormal recordings. In older children tonic,clonic seizures, abnormal behaviour, inconsolable crying, frightened facial expression, sleep disturbance, loss of consciousness, paraesthesia, or intermittent visual symptoms were described during controlled and uncontrolled withdrawal or insufficient dosage. Interpretation, PDE or PNPO should be considered in infants with prolonged episodes of mixed multifocal myoclonic tonic symptoms, notably when associated with grimacing and abnormal eye movements. [source] A Study of 43 Patients with Panayiotopoulos Syndrome, a Common and Benign Childhood Seizure SusceptibilityEPILEPSIA, Issue 1 2003Christina Lada Summary: ,Purpose: To determine prevalence, clinical, EEG features, and prognosis of Panayiotopoulos syndrome and to examine the proposition that clinical manifestations are more important than EEG findings. Methods: We analyzed retrospectively the clinical and EEG records of 1,340 children with one or more focal seizures seen in the last 18 years, supplemented with a prospective study from 1998. Panayiotopoulos syndrome was defined by clinical criteria, mainly ictal emesis, irrespective of EEG findings. Results: We analyzed 43 of 90 patients with Panayiotopoulos syndrome who were seizure free >2 years. Girls predominated. Mean age at first seizure was 5 years. Seizures consisted mainly of autonomic manifestations; ictal emesis was often the first symptom, culminating in vomiting in 86%. Of nonautonomic manifestations, lateral eye deviation was the most common; visual symptoms were exceptional. Impairment of consciousness ensued in all seizures, half of which ended with hemi or generalized convulsions. Nearly 46.5% of cases had at least one seizure >30 min, constituting autonomic status epilepticus. Seizures during sleep (84%) were more common than those in wakefulness. EEG showed occipital spikes in 29 patients. Of the other 14 cases, five had extraoccipital abnormalities or brief generalized discharges, and nine had normal awake and sleep EEG. Prognosis was excellent. All 43 children have been free of seizures for ,2 years, 53% having a single seizure, and 47%, an average two to three seizures. Conclusions: Panayiotopoulos syndrome is common and needs wider recognition. EEG shows occipital or extraoccipital abnormalities, is normal in one third of patients, and does not determine clinical manifestations or prognosis, which is excellent despite the high prevalence of lengthy seizures. [source] Clinical and genetic features of human prion diseases in Catalonia: 1993,2002EUROPEAN JOURNAL OF NEUROLOGY, Issue 10 2004R. Sanchez-Valle We describe the clinical and genetic characteristics of the 85 definite or probable human prion diseases cases died between January 1993 and December 2002 in Catalonia (an autonomous community of Spain, 6 million population). Seventy-three (86%) cases were sporadic Creutzfeld-Jakob diseases (sCJD) (49 definite, 24 probable), with a median age at onset of 66 years. The clinical presentation was dementia in 29 cases, ataxia in 14 and visual symptoms in five. The median survival was 3 months. The 14-3-3 assay was positive in 93% cases, 62% presented periodic sharp wave complexes (PSWC) in EEG but only 18% the typical signs on MRI. Forty-eight sCJD were studied for codon 129 PRNP polymorphism: 69% were methionine/methionine (M/M), 14.5% valine/valine (V/V) and 16.5% M/V. Six out of seven V/V cases did not present PSWC and in two survival was longer than 20 months. Eleven cases (13%) were genetic: five familial fatal insomnia and six familial CJD (fCJD). Up to four (67%) fCJD lacked family history of disease, two presented seizures early at onset and one neurosensorial deafness. The only iatrogenic case was related to a dura mater graft. No case of variant CJD was registered. The study confirms in our population the consistent pattern reported worldwide on human prion diseases. Atypical features were seen more frequently in sporadic 129 V/V CJD and fCJD cases. [source] Pseudomigraine With Lymphocytic Pleocytosis: A Calcium Channelopathy?HEADACHE, Issue 8 2003Clinical Description of 10 Cases, Genetic Analysis of the Familial Hemiplegic Migraine Gene CACNA1A Objective.,To report the clinical findings of 10 patients diagnosed with pseudomigraine with lymphocytic pleocytosis and the results of mutational analysis of the CACNA1A gene in 8 of these patients. Background.,Pseudomigraine with lymphocytic pleocytosis, also referred to as headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HaNDL), is characterized by episodic transient neurologic dysfunction associated with moderate to severe headache and cerebrospinal fluid lymphocytic pleocytosis. Episodes are recurrent and the condition is self-limiting. The etiology of this sporadic condition remains unknown, but the episodic nature and its ability to be triggered by angiography is somewhat reminiscent of the phenotypic features of familial hemiplegic migraine, a condition caused by mutations in the CACNA1A gene. Design/Methods.,Utilizing retrospective chart review, we describe the clinical features of pseudomigraine with lymphocytic pleocytosis in 10 patients. Whole blood was taken from 8 patients (2 were lost to follow-up) and used for DNA testing. The CACNA1A gene was screened for mutations using heteroduplex analysis and direct DNA sequencing. Results.,Clinical features of pseudomigraine with lymphocytic pleocytosis included transient episodes of weakness, sensory and visual symptoms, aphasia, and confusion lasting minutes up to 4 hours. Sensory symptoms, typically affecting the face and arm, were the most common presentation. Localization of symptoms did not conform to vascular territories. Headache was typically throbbing and most often bilateral. Genetic analysis did not identify any mutations in the CACNA1A gene. Conclusions.,Similarities between familial hemiplegic migraine and pseudomigraine with lymphocytic pleocytosis include recurrent headache with reversible neurologic deficit, cerebrospinal fluid lymphocytic pleocytosis, and triggers such as angiography. Even so, heteroduplex analysis and DNA sequencing failed to identify any sporadic mutations or shared polymorphisms in the exons or the intron/exon boundaries of the CACNA1A gene. These results do not support a role of the CACNA1A gene in the etiology of pseudomigraine with lymphocytic pleocytosis. [source] Clinical and Magnetic Resonance Imaging Regression of Progressive Multifocal Leukoencephalopathy in an AIDS Patient After Intensive Antiretroviral TherapyJOURNAL OF NEUROIMAGING, Issue 3 2001Rita A. Shapiro DO ABSTRACT A 36-year-old homosexual man with 6 months of visual symptoms and headaches had right homonymous hemianopia, mild new learning impairment, and alexia with agraphia. The initial brain magnetic resonance imaging (MRI) scan was reported consistent with left occipital infarction. Subsequent MRI demonstrated abnormal demyelination in the subcortical white matter and deep parieto-occipital white matter bilaterally, but primarily left. Human immunodeficiency virus testing and cerebrospinal fluid polymerase chain reaction for JC virus DNA were both positive, consistent with progressive multifocal leukoencephalopathy (PML) with AIDS. His clinical status steadily deteriorated, and MRI white matter abnormalities worsened despite high-dose antiretroviral therapy. After the antiretroviral regimen was intensified by the addition of a protease inhibitor, rapid clinical and radiographic improvement occurred with subsequent MRI studies revealing only residual left parieto-occipital encephalomalacia. PML in AIDS patients has been associated with a nearly uniformly poor prognosis until recent reports of improved outcomes after highly active antiretroviral therapy. This patient with PML and AIDS similarly showed a robust clinical and MRI response to intensive antiretroviral combination therapy, which has been maintained for more than 3 years. [source] Coloured overlays and their benefit for readingJOURNAL OF RESEARCH IN READING, Issue 1 2001Arnold Wilkins Children in mainstream schools compared text on white paper with identical text covered in turn by each of ten differently-coloured plastic overlays. More than 50% reported improved perception with one or more colours, and were given the best colour to use. About half used the overlays for more than three months and their reading speed increased when the overlays were used. In Study I children were examined twice using different methods and examiners. 47% chose the same colour on both occasions, and showed the greatest improvement in reading fluency, reliable at retest. In Study II children were issued with a random colour, and the greatest improvements in reading speed occurred when the random colour was the same as that previously chosen. Phonological reading strategies were not related to visual symptoms, or the benefit from overlays. Across individuals, reading speed varied by a factor of more than three, for good and poor readers. Study III provided estimates of the prevalence of improvements based on a sample of 426 children from 12 schools: 5% of children read more than 25% faster with a coloured overlay. [source] Abnormal visual activation in Parkinson's disease patients,MOVEMENT DISORDERS, Issue 11 2010Ellison Fernando Cardoso MD Abstract Among nonmotor symptoms observed in Parkinson's disease (PD) dysfunction in the visual system, including hallucinations, has a significant impact in their quality of life. To further explore the visual system in PD patients we designed two fMRI experiments comparing 18 healthy volunteers with 16 PD patients without visual complaints in two visual fMRI paradigms: the flickering checkerboard task and a facial perception paradigm. PD patients displayed a decreased activity in the primary visual cortex (Broadmann area 17) bilaterally as compared to healthy volunteers during flickering checkerboard task and increased activity in fusiform gyrus (Broadmann area 37) during facial perception paradigm. Our findings confirm the notion that PD patients show significant changes in the visual cortex system even before the visual symptoms are clinically evident. Further studies are necessary to evaluate the contribution of these abnormalities to the development visual symptoms in PD. © 2010 Movement Disorders Society [source] Pulfrich's phenonenon in a case of optic nerve hypoplasiaOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 1 2008Gordon Heron Introduction:, Optic nerve hypoplasia (ONH) is a congenital deficiency of retinal ganglion cells and their axons that form the optic nerve. This condition is associated with visual deficits ranging from no light perception in severe cases to vision within normal ranges in mild cases of ONH. In mild cases, deficits can be limited to sectoral anomalies in the visual field and normal vision with colour vision anomalies have been reported. We report here a case of mild ONH with visual symptoms relating to Pulfrich phenomenon (PP) occurring spontaneously. Methods:, A 12 year girl presented with typical visual symptoms (bumping into objects when walking, poor object location at tennis) associated with the spontaneous PP. A simple pendulum revealed a perceived anticlockwise ellipse indicative of a left eye defect. This was neutralised by an 85% transmission filter placed before the right eye. The inter-ocular latency difference was calculated to be 0.88 (S.D., 0.55) ms. Results:, Fundus biometry showed an asymmetry in optic nerve size, the left being smaller than the right. Visual fields, anomaloscope and other colour vision tests, and both flash and pattern-reversal stimuli Visually Evoked Potentials showed no difference in visual function between the right and left eyes. Conclusions:, A case of very mild ONH gives inter-ocular normal vision and visual function and yet a subtle inter-ocular delay occurs resulting in visual symptoms associated with PP. These were completely removed with tinted spectacles. [source] Use of chlorophyll fluorescence to evaluate the cold acclimation and freezing tolerance of winter and spring oatsPLANT BREEDING, Issue 5 2001F. Rizza Abstract The efficiency of the excitation capture by open Photosystem II (PSII) reaction centres was measured by the Fv/Fm ratios in a collection of winter and spring oats in order to assess the effects of hardening and freezing on the functionality of PSII and also the suitability of a chlorophyll fluorescence-based method to screen oat cultivars for frost tolerance. A significant reversible decrease in Fv/Fm was found in all genotypes during acclimation to low, non-freezing temperatures. Fv/Fm analysis appears to be an attractive test for the evaluation of frost tolerance in oats, being rapid, non-invasive and capable of monitoring a trait related to a crucial stage in the acquisition of frost tolerance. It is more sensitive and precise than other standard methods and highly correlated with field-evaluated frost damage. The measurements made during recovery 1 or 2 days after stress when the visual symptoms are not yet expressed, were especially advantageous because of the large variability in genotype response. The r-values (close to 0.8) were reduced due to the non-standard behaviour of the winter cultivar ,Aintree'. The cold acclimation response of this genotype has been analysed in detail and the limits of artificial freezing tests are discussed. [source] Effect of banana bunchy top virus infection on morphology and growth characteristics of bananaANNALS OF APPLIED BIOLOGY, Issue 1 2008C.R.R. Hooks Abstract Field experiments were conducted in Oahu, Hawaii, to investigate the effects of banana bunchy top virus (BBTV) infection on growth and morphology of banana (Musa acuminata). The time interval between aphid inoculation of BBTV and the initial appearance of disease symptoms (i.e. incubation period) was also determined. Plants infected with BBTV showed a significant reduction in petiole size (i.e. length and distance), plant canopy and height, leaf area, pseudostem diameter and chlorophyll content compared with control plants. Growth differences between virus-infected and control plants were not observed until 40,50 days after the plants were inoculated with viruliferous aphids. Other growth parameters such as petiole width and leaf production were not statistically different between infected and control plants. The incubation period of banana bunchy top disease or appearance of symptoms ranged from 25 to 85 days after aphid inoculation. However, PCR assays provided earlier detection of BBTV in banana plants compared with visual symptoms. [source] Coeliac disease, unilateral occipital calcifications, and drug-resistant epilepsy: successful lesionectomyACTA NEUROLOGICA SCANDINAVICA, Issue 3 2005K. O. Nakken Purpose , To draw attention to the triad of coeliac disease (CD), occipital calcifications, and drug-resistant epilepsy, with focus on the outcome of epilepsy surgery. Methods , We describe a male patient who despite a diagnosis of CD from the age of 9 did not comply with the gluten-free diet. At the age of 11 he developed simple and complex partial seizures with visual symptoms, anxiety, and ambulatory automatisms. His epilepsy appeared to be drug resistant, and after having tried nine antiepileptic drugs (AEDs), alone or in combinations, he underwent a presurgical evaluation at the age of 30. Interictal standard electroencephalograms (EEGs) disclosed frequent biparieto-occipital epileptiform discharges. Computed tomography showed cortical,subcortical punctate calcifications in the right parieto-occipital region, where his seizures seemed to start, according to ictal EEG registrations from intracranial strip electrodes. Results , At the age of 31 he underwent epilepsy surgery. A 5 × 6 cm large area of the right parieto-occipital region was resected, including the area with calcifications. Except for a few short-lasting episodes of anxiety (simple partial seizures?) he has now been seizure-free for 12 years. AEDs were withdrawn 5 years ago. Postoperatively he was left with an upper left-sided quadrant anopsia, which is not bothering him. Conclusions , In patients with CD, unilateral occipital calcifications, and drug-resistant epilepsy, epilepsy surgery should be considered, as a lesionectomy might be very successful. [source] 4341: Are visual evoked potentials and pattern ERG useful in neuro-ophthalmology?ACTA OPHTHALMOLOGICA, Issue 2010GE HOLDER Purpose To describe the roles of VEP and PERG in clinical neuroophthalmology. Methods Case based examples. Results Objective visual system testing with electrophysiology allows the distinction between optic nerve and macular dysfunction, often difficult in clinical practice. Examples will be shown of the types of VEP abnormality that can occur in different disorders of optic nerve function. PERG should also be performed in the patient with visual symptoms; if the PERG suggests macular dysfunction, full-field ERG is indicated in order to determine whether that macular dysfunction is part of a generalised retinal process or is dysfunction localised to the macula. Electrophysiology further allows the diagnosis of non-organic visual loss and the quantification of visual system dysfunction. Conclusion The objective functional assessment with electrophysiology is an important part of the diagnostic armamentarium available to neuroophthalmologists. [source] 3164: Post-concussive syndromeACTA OPHTHALMOLOGICA, Issue 2010V PURVIN Purpose Over 85% of traumatic brain injuries (TBI) are considered "mild", also referred to as "concussion". Mild TBI is increasingly recognized as an important public health problem. Despite their designation as "mild", adverse outcomes from such injuries are significant, with 25% of patients still impaired at one year. Visual difficulties are common, reported by two-thirds of patients in a Veterans Administration study. Methods Visual symptoms of mild TBI typically include blurring, light sensitivity, eyestrain, difficulty with near focus, trouble tracking, seeing haloes around lights, and diplopia (monocular and binocular). Results Despite the high incidence of visual symptoms, results of standard eye examination and neuro-ophthalmic testing are typically normal. Conventional neuro-imaging also fails to demonstrate objective evidence of neurologic dysfunction in most cases. Recent developments in neuroimaging (particularly diffusion tensor imaging) and serologic testing (S-100B) have provided some correlates of such injury. Conclusion New information from neuroimaging and serologic testing has helped to provide some objective markers for post-concussive syndromes. The diagnosis of such post-traumatic syndromes remains largely clinical. [source] Bilateral diffuse uveal melanocytic proliferation and uterine cancer.ACTA OPHTHALMOLOGICA, Issue 3 2000A case report ABSTRACT. Purpose: To report a case of bilateral diffuse uveal melanocytic proliferation (BDUMP), a rare paraneoplastic syndrome causing visual loss in patients with systemic carcinoma. Results: A 70-year-old woman developed visual symptoms 13 months after surgery and local irradiation therapy for uterine cancer. Following bilateral external beam irradiation supplemented with subsequent drainage of subretinal fluid in the left eye, the visual acuity improved from 0.01 to 0.15 in this eye only. The visual acuity remained at this level until she died 4 1/4 years after the onset of eye symptoms. Conclusion: This is the fourth case that survived longer than 24 months after the onset of visual symptoms of the 22 previously reported cases with BDUMP. It demonstrates that radiotherapy may have a vision-preserving effect in this group of patients. The patient also developed two different paraneoplastic phenomena , a nephrotic syndrome before and BDUMP after treatment for uterine cancer. [source] Craniopharyngioma: a review of long-term visual outcomeCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2003Celia Chen MB BS MPHS Abstract Purpose: To assess the clinical presentation and long-term visual outcome in a series of patients with craniopharyn-gioma. Methods: Retrospective case review. Results: Thirty-six patients were reviewed, comprising 19 female patients and 17 male patients. The age range was 2,77 years with a bimodal distribution of 17 children (mean age 10 years) and 19 adults (mean age 47 years). Blurred vision was the most common visual complaint (23 cases, 64%) and headache the most frequent systemic complaint (19 cases, 53%). The average duration of systemic symptoms was 45 weeks compared to 10 weeks for visual symptoms. Deficits in visual acuity occurred in 13 patients (36%) and showed no significant change from initial presentation to final review. Sixteen patients (44%) had bitemporal hemianopia on presentation and pleomorphism (change from one type of visual field defect to another) occurred in 11 patients. Recurrence of tumour occurred in 15 patients (42%) and was more likely in children (59%) than adults (26%). The mean time period to recurrence was 7 years. The average follow-up period for all cases was 10 years. Conclusion: Patients with craniopharyngioma generally present late, and the visual symptoms are often preceded by a long history of systemic symptoms. Children are more likely to present with systemic symptoms than adults. Visual field pleomorphism is a feature of craniopharyngioma and occurred in one-third of the patients. Local recurrence is common. Although magnetic resonance imaging is the recommended means of follow up, regular neuro-ophthalmic review is useful in the early detection of anterior visual pathway compression by recurrent tumour. [source] Visual signs and symptoms of Parkinson's diseaseCLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 2 2008Richard A Armstrong DPhil Parkinson's disease (PD) is a common disorder of middle-aged and elderly people, in which there is degeneration of the extra-pyramidal motor system. In some patients, the disease is associated with a range of visual signs and symptoms, including defects in visual acuity, colour vision, the blink reflex, pupil reactivity, saccadic and smooth pursuit movements and visual evoked potentials. In addition, there may be psychophysical changes, disturbances of complex visual functions such as visuospatial orientation and facial recognition, and chronic visual hallucinations. Some of the treatments associated with PD may have adverse ocular reactions. If visual problems are present, they can have an important effect on overall motor function, and quality of life of patients can be improved by accurate diagnosis and correction of such defects. Moreover, visual testing is useful in separating PD from other movement disorders with visual symptoms, such as dementia with Lewy bodies (DLB), multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). Although not central to PD, visual signs and symptoms can be an important though obscure aspect of the disease and should not be overlooked. [source] | |||||||||||||