Optic nerve glioma physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Common physical examination findings of optic nerve glioma include nystagmus, strabismus, proptosis, visual impairment, afferent pupillary defect, edema and/or pallor of optic disc, torticollis and deficits of cranial nerve II. | Common physical examination findings of optic nerve glioma include [[nystagmus]], [[strabismus]], [[proptosis]], visual impairment, [[afferent]] [[pupillary]] defect, edema and/or [[pallor]] of optic disc, [[torticollis]] and deficits of [[cranial nerve]] II. | ||
==Physical Examination== | ==Physical Examination== | ||
===Eyes=== | ===Eyes=== | ||
*Nystagmus may be present.<ref name="pmid6739045">{{cite journal| author=Lavery MA, O'Neill JF, Chu FC, Martyn LJ| title=Acquired nystagmus in early childhood: a presenting sign of intracranial tumor. | journal=Ophthalmology | year= 1984 | volume= 91 | issue= 5 | pages= 425-53 | pmid=6739045 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6739045 }} </ref><ref name="pmid8531033">{{cite journal| author=Arnoldi KA, Tychsen L| title=Prevalence of intracranial lesions in children initially diagnosed with disconjugate nystagmus (spasmus nutans) | journal=J Pediatr Ophthalmol Strabismus | year= 1995 | volume= 32 | issue= 5 | pages= 296-301 | pmid=8531033 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8531033 }} </ref> | *[[Nystagmus]] may be present.<ref name="pmid6739045">{{cite journal| author=Lavery MA, O'Neill JF, Chu FC, Martyn LJ| title=Acquired nystagmus in early childhood: a presenting sign of intracranial tumor. | journal=Ophthalmology | year= 1984 | volume= 91 | issue= 5 | pages= 425-53 | pmid=6739045 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6739045 }} </ref><ref name="pmid8531033">{{cite journal| author=Arnoldi KA, Tychsen L| title=Prevalence of intracranial lesions in children initially diagnosed with disconjugate nystagmus (spasmus nutans) | journal=J Pediatr Ophthalmol Strabismus | year= 1995 | volume= 32 | issue= 5 | pages= 296-301 | pmid=8531033 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8531033 }} </ref> | ||
*Strabismus may be present | *[[Strabismus]] may be present | ||
*Visual impairment may be present | *Visual impairment may be present | ||
*Proptosis | *[[Proptosis]] | ||
*Afferent pupillary defect may be present | *[[Afferent]] [[pupillary]] defect may be present | ||
*Fundoscopic examination may show pallor and/or edema of the optic disc due to atrophy. Initially, optic nerve head is swollen but subsequently it becomes atrophic. Central | *[[Fundoscopic]] examination may show [[pallor]] and/or [[edema]] of the optic disc due to [[atrophy]]. Initially, optic nerve head is swollen but subsequently it becomes atrophic. [[Central]] [[retinal]] [[vein]] occlusion and [[optociliary]] collaterals may occasionally be seen. | ||
*On slit-lamp examination iris hamartomas (Lisch nodules) may be identified in optic nerve glioma patients with associated NF-1. | *On slit-lamp examination iris hamartomas (Lisch nodules) may be identified in optic nerve glioma patients with associated NF-1. | ||
===Head=== | ===Head=== | ||
*Torticollis may be present<ref name="pmid7069562">{{cite journal| author=Koenig SB, Naidich TP, Zaparackas Z| title=Optic glioma masquerading as spasmus nutans. | journal=J Pediatr Ophthalmol Strabismus | year= 1982 | volume= 19 | issue= 1 | pages= 20-4 | pmid=7069562 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7069562 }} </ref> | *[[Torticollis]] may be present<ref name="pmid7069562">{{cite journal| author=Koenig SB, Naidich TP, Zaparackas Z| title=Optic glioma masquerading as spasmus nutans. | journal=J Pediatr Ophthalmol Strabismus | year= 1982 | volume= 19 | issue= 1 | pages= 20-4 | pmid=7069562 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7069562 }} </ref> | ||
===Neurological=== | ===Neurological=== | ||
*Mental status may be altered if obstructive hydrocephalus is present | *Mental status may be altered if [[obstructive hydrocephalus]] is present' | ||
*There are deficits in cranial nerves II- Involuntary eyeball movement and loss of peripheral vision in one or both eyes may be present. | *There are deficits in [[cranial nerves]] II- Involuntary eyeball movement and loss of [[peripheral]] vision in one or both [[eyes]] may be present. | ||
===Skin=== | ===Skin=== | ||
*Lesions may be present: | *Lesions may be present: | ||
**Café-au-lait spots or hyperpigmented macules may be present in patients with optic pathway glioma associated with NF-1. | **Café-au-lait spots or hyperpigmented macules may be present in patients with optic pathway glioma associated with [[NF-1]]. | ||
**Axillary or inguinal freckles may be present in patients with optic nerve glioma associated with NF-1 | **[[Axillary]] or [[inguinal]] freckles may be present in patients with optic nerve glioma associated with NF-1' | ||
Revision as of 18:34, 5 October 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Common physical examination findings of optic nerve glioma include nystagmus, strabismus, proptosis, visual impairment, afferent pupillary defect, edema and/or pallor of optic disc, torticollis and deficits of cranial nerve II.
Physical Examination
Eyes
- Nystagmus may be present.[1][2]
- Strabismus may be present
- Visual impairment may be present
- Proptosis
- Afferent pupillary defect may be present
- Fundoscopic examination may show pallor and/or edema of the optic disc due to atrophy. Initially, optic nerve head is swollen but subsequently it becomes atrophic. Central retinal vein occlusion and optociliary collaterals may occasionally be seen.
- On slit-lamp examination iris hamartomas (Lisch nodules) may be identified in optic nerve glioma patients with associated NF-1.
Head
- Torticollis may be present[3]
Neurological
- Mental status may be altered if obstructive hydrocephalus is present'
- There are deficits in cranial nerves II- Involuntary eyeball movement and loss of peripheral vision in one or both eyes may be present.
Skin
- Lesions may be present:
References
- ↑ Lavery MA, O'Neill JF, Chu FC, Martyn LJ (1984). "Acquired nystagmus in early childhood: a presenting sign of intracranial tumor". Ophthalmology. 91 (5): 425–53. PMID 6739045.
- ↑ Arnoldi KA, Tychsen L (1995). "Prevalence of intracranial lesions in children initially diagnosed with disconjugate nystagmus (spasmus nutans)". J Pediatr Ophthalmol Strabismus. 32 (5): 296–301. PMID 8531033.
- ↑ Koenig SB, Naidich TP, Zaparackas Z (1982). "Optic glioma masquerading as spasmus nutans". J Pediatr Ophthalmol Strabismus. 19 (1): 20–4. PMID 7069562.