Binasal congruous hemianopia secondary to functional visual loss: A case report.

Introduction: To describe an unusual case of binasal congruous hemianopia secondary to functional visual loss (FVL).

Patient Concerns: A 24 year-old male was referred originally by his optician at the Emergency Eye Department of the Leicester Royal Infirmary in October 2018 with visual field changes affecting the nasal field of vision in both eyes on routine eye examination. The patient reported ongoing headaches over the last 6 weeks to 8 weeks associated with simultaneous peripheral visual field changes.

Anti-NMDA-receptor encephalitis presenting with catatonia and neuroleptic malignant syndrome in patients with intellectual disability and autism.

We report anti-N-methyl-d-aspartate (NMDA) receptor encephalitis in two patients with autism and intellectual disability presenting with neuropsychiatric symptoms of catatonia and neuroleptic malignant syndrome. Case reports such as these help raise awareness of this clinical issue. By paving the way for earlier diagnoses they ultimately maximise the potential for curative treatments and prevention of long-term complications.

Morphology of retinal vessels in patients with optic nerve head drusen and optic disc edema.

Purpose: We quantitatively investigated the peripapillary vascular morphology in patients with optic nerve head drusen (ONHD) and optic disc edema (ODE).

Methods: Computer-based fundus analysis was used to investigate peripapillary vascular morphology, including length, branching, and diameter of arteries and veins calibrated by optical coherence tomography.

Results: Patients with ONHD showed significantly larger diameters of arteries without branching (P = 0.

Rating papilloedema: an evaluation of the Frisén classification in idiopathic intracranial hypertension.

The appearance of the optic disc is a key measure of disease status in idiopathic intracranial hypertension (IIH). The Frisén classification describes stages of optic disc swelling (grades 0-5). It is the only classification of papilloedema, and is used internationally in clinical and research practice.

Melanoma associated retinopathy and how to understand the electroretinogram.

Melanoma associated retinopathy is a rare paraneoplastic complication of metastatic cutaneous malignant melanoma. It may present years after the original diagnosis of melanoma. Here we describe a patient with this condition who presented with persistent photopsias and visual loss.

A randomised controlled trial of treatment for idiopathic intracranial hypertension.

The cause of idiopathic intracranial hypertension (IIH) remains unknown, and no consensus exists on how patients should be monitored and treated. Acetazolamide is a common treatment but has never been examined in a randomised controlled trial. The objectives of this pilot trial are to prospectively evaluate the use of acetazolamide, to explore various outcome measures and to inform the design of a definitive trial in IIH.

Low energy diet and intracranial pressure in women with idiopathic intracranial hypertension: prospective cohort study.

Objective: To observe intracranial pressure in women with idiopathic intracranial hypertension who follow a low energy diet.

Design: Prospective cohort study.

Setting: Outpatient department and the clinical research facility based at two separate hospitals within the United Kingdom.

Altered mental state and the Whipple triad.

A 47-year-old man presented with episodes of altered mental state initially felt to be complex partial seizures, but which were in fact hypoglycaemic episodes. An insulinoma was confirmed and eventually localised. He underwent an abdominal computed tomography scan and intraoperative laparoscopy, but required selective venous sampling to localise the tumour.

Paroxysmal extreme pain disorder M1627K mutation in human Nav1.7 renders DRG neurons hyperexcitable.

Background: Paroxysmal extreme pain disorder (PEPD) is an autosomal dominant painful neuropathy with many, but not all, cases linked to gain-of-function mutations in SCN9A which encodes voltage-gated sodium channel Nav1.7. Severe pain episodes and skin flushing start in infancy and are induced by perianal probing or bowl movement, and pain progresses to ocular and mandibular areas with age.

Optic nerve sheath fenestration for intracranial hypertension associated with chronic inflammatory demyelinating polyneuropathy.

The authors report a case of papilledema in a 61-year-old woman with chronic demyelinating polyneuropathy. The cerebrospinal fluid protein level was elevated (2.68 to 4.

Headache and CNS white matter abnormalities associated with gluten sensitivity.

The authors describe 10 patients with gluten sensitivity and abnormal MRI. All experienced episodic headache, six had unsteadiness, and four had gait ataxia. MRI abnormalities varied from confluent areas of high signal throughout the white matter to foci of high signal scattered in both hemispheres.

Electro-oculography, electroretinography, visual evoked potentials, and multifocal electroretinography in patients with vigabatrin-attributed visual field constriction.

Purpose: Symptomatic visual field constriction thought to be associated with vigabatrin has been reported. The current study investigated the visual fields and visual electrophysiology of eight patients with known vigabatrin-attributed visual field loss, three of whom were reported previously. Six of the patients were no longer receiving vigabatrin.

Visual field defects associated with vigabatrin therapy.

Objective: To estimate the prevalence of visual field defects in patients taking the anticonvulsant drug vigabatrin and to characterise the features of visual dysfunction found.

Methods: Thirty three unselected patients attending neurology and epilepsy clinics were identified as taking vigabatrin and asked to attend for neuro-ophthalmic evaluation. A control group of 16 patients with epilepsy unexposed to vigabatrin was also evaluated.

Inherited prion disease with an alanine to valine mutation at codon 117 in the prion protein gene.

A large English family with autosomal dominant segregation of presenile dementia, ataxia and other neuropsychiatric features is described. Diagnoses of demyelinating disease, Alzheimer's disease, Creutzfeldt-Jakob disease (CJD) and Gerstmann-Sträussler-Scheinker syndrome have been attributed to particular individuals at different times. An Irish family, likely to be part of the same kindred, is also described, in which diagnoses of multiple sclerosis, dementia, corticobasal degeneration and new variant CJD have been considered in affected individuals.

Remembered saccades with variable delay in Parkinson's disease.

The effect of increasing delay on the metrics of remembered saccades was studied in 10 subjects with mild Parkinson's disease, none of whom was receiving treatment with L-dopa, and nine age-matched control subjects. Delays of 1 msec, 250 msec, 1000 msec, 2500 msec, and 5000 msec were used, and reflexive saccades used as a control condition. Results were analyzed for the gain of the primary saccade and the accuracy of the final eye position (FEP gain).