Neuro-otology and Neuro-ophthalmology - DocNeuro

Labyrinthitis Ossificans

Christopher Buckle MD — Tue, 15 Jul 2014 14:59:22 +0000

What anatomic structure of the middle or inner ear is abnormal in this patient with hearing loss and a history of childhood meningitis? A. Ossicular chain B. Otic capsule C. Oval window D. Cochlea Answer: This cochlea is ossified; the cochlea is normally fluid filled and therefore low density on CT. (A) axial non contrast […]

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Anton’s Syndrome

Naoum P. Issa MD PhD — Sun, 08 Sep 2013 20:03:27 +0000

Anton’s syndrome consists of cortical blindness without the patient acknowledging or recognizing that they cannot see. The patient confabulates, answering questions about what they cannot see with confidence and insisting they can see. This often leads to delay in recognizing the condition since the patient does not acknowledge seeing difficulties and visual problems are often […]

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Facial colliculus

Naoum P. Issa MD PhD — Thu, 23 May 2013 20:51:53 +0000

The facial colliculi sit on the dorsal aspect of the pons, forming part of the floor of the fourth ventricle. Both facial colliculi are highlighted in the image below. Lesions that affect bilateral facial colliculi are rare, but in the case shown here both are affected by what is likely multiple sclerosis or other demyelinating […]

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Oculocephalic Reflex

Naoum P. Issa MD PhD — Mon, 18 Mar 2013 13:49:32 +0000

The oculocephalic reflex is also called the doll’s eye reflex, so named because dolls that have movable eyes exhibit the same eye movement. In a comatose patient, if the head is tilted to one side, the eyes move towards the contralateral side. In a conscious patient, such movement is inhibited by the cerebellum. Thus, if […]

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Temporal Arteritis

Jeffrey Waggoner MD — Fri, 15 Mar 2013 22:03:18 +0000

Temporal arteritis is a commonly used term that refers to an inflammation of the temporal artery. There is some confusion about terminology since this entity is also referred to as giant cell arteritis. This latter term describes the pathologic appearance inflamed arteries—infiltrated by multinucleated giant cells as well as lymphocytes and plasma cells. This entity […]

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Optic Neuritis

Jeffrey Waggoner MD — Fri, 15 Mar 2013 22:00:59 +0000

Optic neuritis is inflammation of the optic nerve. It is principally due to demyelinization and is closely associated with multiple sclerosis (MS). Potential etiologies of optic neuritis Almost one fifth of new cases of MS present as an optic neuritis. Studies estimate that 40% to 50% of MS patients will eventually develop an optic neuritis. […]

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Dizziness

Jeffrey Waggoner MD — Fri, 15 Mar 2013 21:48:26 +0000

As a complaint, dizziness and vertigo are as common as back pain and headache. Any seasoned primary care physician will testify to the difficulties posed by dizzy patients. They can be both frustrating and confusing, and a patient who is dizzy and tired represents the iconic test of a practitioner’s patience. A systematic approach to […]

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Acute Hearing Loss

Jeffrey Waggoner MD — Fri, 15 Mar 2013 21:43:28 +0000

Acute hearing loss can be secondary to a simple, common cause or can be what is considered a medical emergency. It is a circumstance that should be looked upon as serious until it has been reasonably well defined. Acute primary hearing loss is called sudden hearing loss (SHL). It can be caused by viral and […]

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Acoustic Neuroma

Jeffrey Waggoner MD — Fri, 15 Mar 2013 21:41:37 +0000

Acoustic neuromas (more properly called vestibular schwannomas) arise from the Schwann cell sheath of either the vestibular or the cochlear nerve. They account for four-fifths of cerebellopontine angle tumors (the remaining 20% are mostly meningiomas.) Most of the schwannomas are derived from the vestibular portion of the vestibulocochlear nerve. Less than 5% arise from the […]

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Vision Loss

Jeffrey Waggoner MD — Fri, 15 Mar 2013 21:29:46 +0000

Acute vision loss may be caused by central retinal artery occlusion, central vein occlusion, temporal arteritis, optic neuritis, optic neuropathy, vitreous hemorrhage, retinal detachment, neovascular age-related macular degeneration, stroke, hysterical conversion reactions, or malingering. Acute vision loss may last minutes or hours, amaurosis fugax. Causes of this entity include ocular migraine, emboli to retinal arteries, […]

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