Abstract:
A 40-year-old man who attended the emergency department with a scotoma in right eye. He mentioned hearing difficulties and headache for months and he had sensory and motor deficits in the previous days. In the ophthalmic examination, the right eye had areas of arterial occlusion. MRI revealed hyperintense lesions. The patient was diagnosed with Susac syndrome. He was treated with systemic steroids, however, it was not enough to control the condition. Rituximab and intravenous immunoglobulins were added, which allowed the improvement of neurological symptoms, but the alteration of the visual field and the hearing defect did not recover. Early diagnosis of this pathology is essential, since delaying treatment can cause irreversible consequences. Sometimes it is difficult given the wide variety of symptoms and the course of the disease. Ocular manifestations may raise suspicion when the general symptoms are nonspecific.
摘要:
一名40岁的男子因右眼暗点进入急诊科。他提到听力困难和头痛几个月,前几天他有感觉和运动缺陷。在眼科检查中,右眼有动脉闭塞区域。MRI显示高强度病变。患者被诊断为Susac综合征。他接受了全身性类固醇治疗,然而,仅仅控制病情是不够的。加入利妥昔单抗和静脉注射免疫球蛋白,可以改善神经系统症状,但是视野的改变和听力缺陷没有恢复。这种病理的早期诊断至关重要,因为延迟治疗会导致不可逆转的后果。有时很难考虑到各种各样的症状和病程。当一般症状是非特异性时,眼部表现可能会引起怀疑。