Enlarged and Enhancing Optic Nerves in Advanced Glial Fibrillary Acidic Protein Meningoencephalomyelitis.

White, Daniel, Mollan, Susan P, Ramalingam, Satheesh, Nagaraju, Santhoosh, Hayton, Tom and Jacob, Saiju (2019) Enlarged and Enhancing Optic Nerves in Advanced Glial Fibrillary Acidic Protein Meningoencephalomyelitis. Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society. ISSN 1536-5166.

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Abstract

A 36-year-old woman presented with intermittent fever, nausea and vomiting, generalized polyarthralgias, and bilateral optic disc swelling. She had a history of difficult-to-control myasthenia gravis since the age of 18 years. Lumbar puncture demonstrated a normal opening pressure; cerebrospinal fluid (CSF) was remarkable for high protein, low glucose, and a mononuclear pleocytosis. Although initial MRI of the brain was normal, a repeat study 8 weeks later revealed enlarged and enhancing bilateral intraorbital and intracranial optic nerves. After a nondiagnostic brain biopsy, a CSF sample tested positive for antibodies to glial fibrillary acidic protein (GFAP). Findings in this case indicate that optic nerve swelling encountered in GFAP meningoencephalomyelitis is more likely due to optic nerve inflammation rather than elevated intracranial pressure.

Item Type: Article
Subjects: WL Nervous system. Neurology
WW Eyes. Ophthalmology
Divisions: Ambulatory Care > Ophthalmology
Emergency Services > Neurology
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Depositing User: Mr Philip O'Reilly
Date Deposited: 16 Aug 2019 13:49
Last Modified: 17 Feb 2021 10:43
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2305

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