Myelin Oligodendrocyte Glycoprotein (MOG) Ab: positive 1:1000.Neuromyeltis optica (NMO) /Aquaporin-4-IgG Ab: negative.Meningitis/encephalitis panel: negative for bacterial and viral agents.Pink, hazy, no xanthochromia, total protein: 22, glucose: 73, RBC: 1000, total nucleated cells: 8 (0 neutrophils, 7 lymphocytes), opening pressure 26cm Lumbar puncture w/ cytology and opening pressure:.Bartonella henselae IgG/IgM titer: negative.Anti-neutrophil cytoplasmic antibody: negative.Anti-double stranded DNA quantitative: 6 (ref 0-4 IU/mL).Anti-double stranded DNA qualitative: indeterminant.MRI cervical, thoracic, lumbar spine: normal.(Figure 2) MRI brain and orbits w/ and w/o contrast: enhancement and enlargement of intraorbital segments of optic nerves, left > right.Intracranial mass with obstructive hydrocephalus and compression of anterior visual pathway.Cup-to-disc: no cup noted in either optic nerve.OS: Grade II disc edema, no pallor, no hemorrhages, no exudates.OD: Grade I disc edema, no pallor, no hemorrhages, no exudates.Iris: Normal architecture, pharmacologically dilated OU.Deferred in the setting of poor visual acuity.OS: 7.5mm in dim light, constricting to 6.5mm with bright light minimally reactive secondary to pharmacologic dilation prior to arrivalĬonfrontational Visual Fields (count fingers).OD: 7.5mm in dim light, constricting to 6.5mm with bright light minimally reactive secondary to pharmacologic dilation prior to arrival.
MOG SYMPTOMS FULL
Full versions in both eyes (OU) but painful.No other recent illnesses or changes in her health were reported by mom. Treated urinary tract infection several weeks ago.No notable stressors at home or at school.Great aunt – possible similar symptoms at a young age.The patient’s mom reported no cats or other animals in the household, no recent travel, no recent outdoor activities such as hiking, and no recent reported tick bites. She denied nausea, vomiting, ringing in her ears, diplopia, or episodes of transient vision loss Additionally, headaches were present which worsened when lying down. The child’s mother stated that her daughter began having difficulty distinguishing colors prior to the onset of her vision loss and described colors as appearing “dim.” The child also endorsed mild achiness of the left eye with subsequent achiness of the right eye both associated with the onset of blurry vision. Chief Complaint: Progressive vision loss left > rightĪ 9-year old female was referred to the University of Iowa to undergo additional evaluation for profound vision loss with “optic disc swelling.” The child presented with her mother and related progressive blurry vision of both eyes that began 4 days prior to evaluation.
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