Spasm of accommodation in a patient with increased intracranial pressure and pineal cyst

Détails

ID Serval
serval:BIB_C774B700E8A4
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Spasm of accommodation in a patient with increased intracranial pressure and pineal cyst
Périodique
Klinische Monatsblatter fur Augenheilkunde
Auteur(s)
Kawasaki  A., Borruat  F. X.
ISSN
0023-2165 (Print)
Statut éditorial
Publié
Date de publication
03/2005
Volume
222
Numéro
3
Pages
241-3
Notes
Case Reports
Journal Article --- Old month value: Mar
Résumé
BACKGROUND: In the setting of a normal neurological examination, accommodation spasm is frequently attributed to a non-organic etiology. Occasionally, organic disorders are associated. In particular, central lesions involving the dorsal midbrain and quadrigeminal plate have been described with disorders of accommodation. HISTORY AND SIGNS: A 36-year-old woman with idiopathic intracranial hypertension (IIH) had visual blur from pseudo-myopia due to accommodative spasm. Magnetic resonance imaging (MRI) revealed a pineal cyst that was reported to be an incidental finding. The patient had persistent papilledema and recurrent episodes of unilateral and bilateral visual blur from accommodative spasm despite medical management. THERAPY AND OUTCOME: A lumboperitoneal shunt effectively lowered her intracranial pressure (ICP). Thereafter, all symptoms of increased ICP, accommodative spasm and papilledema resolved. A functional, non-organic cause for accommodation spasm was not suspected. CONCLUSIONS: To our knowledge, this is the first report of isolated accommodative spasm as a presenting symptom in a patient with IIH. The patient's accommodative spasm resolved with lowering of the ICP. It remains speculative whether her pineal cyst played a role in triggering the accommodative spasm.
Mots-clé
Accommodation, Ocular/*physiology Adult Central Nervous System Cysts/*diagnosis Cerebrospinal Fluid Shunts Humans Incidental Findings Intracranial Hypertension/*diagnosis/surgery Magnetic Resonance Imaging Male Pineal Gland/*pathology Spasm/diagnosis/*etiology/surgery
Pubmed
Web of science
Création de la notice
28/01/2008 12:37
Dernière modification de la notice
20/08/2019 15:42
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