RESUMO
We present three cases, where young patients had unilateral disc edema with normal optic nerve function. We diagnosed their disease as big blind spot syndrome (BBSS). What is remarkable, however, is that in two of the three cases the extent of the visual field defect considerably exceeded the one regularly emerging in BBSS, which caused us some difficulty in differential diagnosis. The characteristics and the differential diagnostic questions of the big blind spot syndrome are summarised and we would like to draw attention to this unusual, but probably not very rare, form of it.
Assuntos
Escotoma/diagnóstico , Escotoma/fisiopatologia , Campos Visuais , Adulto , Anti-Inflamatórios/uso terapêutico , Betametasona/análogos & derivados , Betametasona/uso terapêutico , Diagnóstico Diferencial , Combinação de Medicamentos , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Disco Óptico/fisiopatologia , Escotoma/tratamento farmacológico , Síndrome , Resultado do TratamentoRESUMO
In this study, we present two cases of different eye movement disorders with variable case histories but with the same end stage; abduction paresis of one of the eyes, which ceased when the other eye was covered. Our differential diagnosis is that either the ocular form of myasthenia gravis, convergence spasm or ocular myotonia could explain the symptoms. However, we hypothesize that the clinical picture corresponds to pseudo abducens palsy or focal dystonia of the extraocular muscle, which in turn could be the result of impaired inhibition of the tonic resting activity of the antagonistic medial rectus muscle. We offer an explanation for the patomechanism of pseudoabducens palsy and the variants of internuclear ophthalmoplegia.
Assuntos
Nervo Abducente , Movimentos Oculares , Miastenia Gravis/diagnóstico , Miotonia/diagnóstico , Oftalmoplegia/diagnóstico , Paralisia/etiologia , Encéfalo/patologia , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-IdadeRESUMO
We present the characteristics of posterior cortical atrophy--a very rare cortical dementia--in a 69 year old woman's case. Our patient's symptoms began with a visual problem which was initially explained by ophthalmological disorder. After neurological exam visual agnosia was diagnosed apart from other cognitive disorder (alexia without agraphia, acalculia, prosopagnosia, constructional disorder, clock-time recognition disorder, dressing apraxia, visuospatial disorientation). The brain MRI showed bilateral asymmetric parieto-occipital atrophy which is characteristic of posterior cortical atrophy.