RESUMEN
The use of IV methylprednisolone has been shown to be associated with some adverse effects. The most feared side effect is acute gastrointestinal perforation and accelerated hypertension particularly during pulse therapy. Hiccups occur less frequently but can cause high levels of discomfort to the patient. In intractable cases, respiratory arrest and death can occur. This article reports the occurrence of hiccups in a patient managed for pseudo Foster-Kennedy syndrome. The hiccups were observed shortly after IV methylprednisolone was administered to the patient and abetted over a period of one week after it was discontinued. Hiccups occur through the neuronal pathway of the hiccup reflex arc, comprising the vagus nerve, phrenic nerve, parts of the sympathetic nervous system (T6-T12), and efferent fibers from the phrenic nerve that supply the glottis and the accessory muscles of respiration. The hiccups resolved with the use of gabapentin. This case report aims to add to the existing body of knowledge of the efficacy of gabapentin in the management of hiccups.
RESUMEN
PURPOSE: To review recurrent NAION as a cause for PFK syndrome. METHODS: In an observational study patients presenting with sudden loss of vision were evaluated. We reviewed patients presenting with disc edema on one side and optic atrophy in contralateral eye on fundus examination. Their visual field defects and fundus fluorescein angiography was assessed. RESULTS: Of the 7 patients evaluated 4 (57.1%) were females. Mean age at presentation was 53.7±11.9years. Mean duration between the two episodes was 12.7months (range: 2-30). The visual acuity of presenting eye ranged from 6/9 to worse counting fingers close to face. CONCLUSIONS: The diagnosis in a PFK presentation is essentially one of exclusion. Patients with NAION are at risk for recurrence in fellow eye, thereby presenting as PFK syndrome. NAION should be considered as a differential especially when imaging and other laboratory investigations are not suggestive of any compressive lesion.
Asunto(s)
Enfermedades del Nervio Óptico/diagnóstico , Enfermedades del Nervio Óptico/etiología , Neuropatía Óptica Isquémica/complicaciones , Neuropatía Óptica Isquémica/diagnóstico , Adulto , Anciano , Atrofia , Encéfalo/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Disco Óptico/diagnóstico por imagen , Agudeza VisualRESUMEN
Objective: To report a case of Pseudo-Foster Kennedy (PFK) syndrome and describe its clinical and paraclinical particularities, as well as the diagnostic difficulties and established treatment. Methods: The case of a 60-year-old male patient with sudden, painless visual impairment in the left eye (LE), and a medical history of old optic nerve atrophy in his right eye (RE) was described. Results: The diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) was established based on the medical history, local and general clinical and paraclinical examination, and temporal artery biopsy. Conclusions: Although there is no current generally accepted treatment for NAION, a correct diagnosis and supportive treatment may contribute to the improvement in visual acuity (VA), improvement that in this case remained stable for 6 months after the onset. The patient is still being monitored and no relapses have been noted.