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Biomedical subjects

Jorge C Kattah

Publications and source records attributed to Jorge C Kattah.

9 recordsLinked to original sources

Resolution of optic nerve edema and improved visual function after optic nerve sheath fenestration in a patient with osteopetrosis.

PURPOSE: To describe the outcome of a patient with visual loss and optic nerve edema that resulted from osteopetrosis who underwent an optic nerve sheath fenestration (ONSF). DESIGN: Interventional case report. METHODS: A 33-year-old man with osteopetrosis had bilateral visual field loss and optic nerve edema. Computed tomography and magnetic resonance imaging demonstrated open optic canals. Although a lumbar puncture showed a normal opening pressure, there were other findings that were suggestive of increased intracranial pressure. The patient elected to undergo a unilateral optic nerve sheath fenestration. RESULTS: After ONSF, the patient experienced markedly improved visual acuity, visual field, and optic nerve appearance. CONCLUSION: Individuals with visual loss and optic disk edema that is associated with osteopetrosis may benefit from ONSF if the optic canals appear to be open and the optic nerve edema is thought to be related to increased intracranial pressure.

Adult↗

Downbeat nystagmus as a result of lamotrigine toxicity.

BACKGROUND: Downbeat nystagmus (DBN) has been reported with phenytoin and carbamazepine toxicity. DBN has not been described as a result of lamotrigine toxicity. METHODS: Clinical records, neuroimaging and video recordings were obtained in two patients diagnosed with intractable epilepsy who developed oscillopsia and incoordination while being treated with lamotrigine. One patient had a videonystagmographic (VNG) study. DISCUSSION: Lamotrigine's half-life is extended when used with valproic acid; hence, the increased chance of neurotoxicity associated with DBN. In our cases, DBN and truncal ataxia occurred in conjunction with toxic lamotrigine serum levels. CONCLUSION: Anticonvulsant toxicity should be considered as a cause of DBN. Lamotrigine toxicity may be an unusual cause.

Adult↗

Bilateral occipital lobe hyperperfusion demonstrated by single photon emission computed tomography during seizure-related cortical blindness.

An 81-year-old woman with chronic dementia developed lethargy, confusion, binocular blindness, and episodic left-beating nystagmus. Diffusion magnetic resonance imaging (MRI) revealed high signal in the right occipital region suggesting recent ischemia. A concurrent electroencephalogram (EEG) showed a right occipital seizure focus that spread to the opposite occipital lobe. A single photon emission computed tomography (SPECT) performed during the seizure epoch showed bilateral occipital lobe hyperperfusion. This is the second report to document SPECT bi-occipital hyperperfusion in seizure-related cortical blindness.

Aged↗

Superior oblique myokymia.

Superior oblique myokymia (SOM) is an uncommon, monocular movement disorder involving rapid torsional, low-amplitude contractions of the superior oblique muscle that causes monocular oscillopsia and diplopia. Ocular and neurologic examination in these patients is usually normal, and the clinical course is characterized by exacerbation remissions with good response to medical treatment. In this review, we present recent advances in the pathogenesis of SOM and provide an algorithm for the investigation and management of these patients.

Adult↗

Bilateral internuclear ophthalmoplegia following minor head trauma.

Internuclear ophthalmoplegia (INO) is characterized by pathognomonic findings on neurological examination. It results from a lesion in the medial longitudinal fasciculus (MLF) and is rarely caused by head trauma. The neuroanatomy of INO is complex and the mechanism by which trauma causes this syndrome is controversial. In the context of trauma, INO occurs frequently in association with other neurological findings and should prompt a thorough investigation and ICU admission. A case of an individual with acute post-traumatic INO is reported and discussed.

Adult↗