RESUMO
A case of bilateral toxic optic neuropathy that developed in the setting of prolonged oral ciprofloxacin use for the treatment of chronic osteomyelitis is described. The patient experienced progressive, bilateral and symmetrical visual loss, central scotomas and loss of colour vision over a 2-month period. The visual symptoms improved immediately upon cessation of ciprofloxacin with a gradual and near complete recovery over several years.
Assuntos
Anti-Infecciosos/efeitos adversos , Ciprofloxacina/efeitos adversos , Doenças do Nervo Óptico/induzido quimicamente , Administração Oral , Doença Crônica , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Nervo Óptico/fisiopatologia , Osteomielite/tratamento farmacológico , Transtornos da Visão/induzido quimicamente , Transtornos da Visão/fisiopatologia , Acuidade Visual , Testes de Campo Visual , Campos VisuaisRESUMO
Superficial siderosis of the central nervous system (CNS) is a rare condition that is thought to be caused by repeated subarachnoid haemorrhages. The major clinical features are progressive bilateral hearing loss, cerebellar ataxia and pyramidal dysfunction. Ante-mortem diagnosis is now possible due to MRI and post mortem reports of this condition are becoming rare. Despite the occurrence of typical clinical features the diagnosis is often missed during life if CT scanning alone is performed. We describe a case of superficial siderosis of the CNS with clinical and post mortem findings as a reminder of this unusual condition.
Assuntos
Ataxia/etiologia , Ataxia/metabolismo , Surdez/etiologia , Surdez/metabolismo , Ferro , Siderose/complicações , Idoso de 80 Anos ou mais , Ataxia/diagnóstico , Surdez/diagnóstico , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Mudanças Depois da Morte , Tomografia Computadorizada por Raios X/métodosRESUMO
Giant cell (temporal) arteritis is a severe potentially fatal systemic vasculitis characterized by focal involvement of the cranial arteries resulting in ischaemic arterial occlusion. The case is presented of a 75-year-old woman with presumed giant cell arteritis and normal bilateral temporal artery biopsies. Despite a seemingly adequate course of systemic steroid therapy, the patient developed sudden catastrophic vision loss. Cerebral angiography and ultrasonography were useful investigations to determine the most appropriate artery to biopsy to confirm the diagnosis of giant cell arteritis.