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Opara NU. Cortical Blindness Due to Neurocysticercosis in an Adolescent Patient. Trop Med Infect Dis 2022; 7:96. [PMID: 35736975 PMCID: PMC9230689 DOI: 10.3390/tropicalmed7060096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 11/16/2022] Open
Abstract
Neurocysticercosis (NCC) is a common cause of recent-onset seizures in both adults and children in tropical areas, especially when there is no other suggestion of another underlying neurological disorder. In addition, there have been reports of very rare cases of bilateral cortical blindness caused by this helminth in children. It is still unclear whether healthy adolescents with no pre-existing health problems could be vulnerable to developing such sequelae due to NCC. We report a case of a 14-year-old African boy from Nigeria with bilateral cortical blindness caused by NCC due to Taenia solium. According to the boy's mother, symptoms began with headaches, vomiting, fatigue, visual loss, and fever (40.0 °C). Clinical investigations led to a diagnosis of cortical blindness and encephalitis due to NCC. Appropriate treatment was administered, and it resulted in the resolution of most symptoms, though the patient remained permanently blind.
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Affiliation(s)
- Nnennaya U Opara
- Department of Emergency Medicine, Charleston Area Medical Center, Institute for Academic Medicine, Charleston, WV 25304, USA
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Carrick FR, Azzolino SF, Hunfalvay M, Pagnacco G, Oggero E, D’Arcy RCN, Abdulrahman M, Sugaya K. The Pupillary Light Reflex as a Biomarker of Concussion. Life (Basel) 2021; 11:life11101104. [PMID: 34685475 PMCID: PMC8537991 DOI: 10.3390/life11101104] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/28/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
The size of our pupils changes continuously in response to variations in ambient light levels, a process known as the pupillary light reflex (PLR). The PLR is not a simple reflex as its function is modulated by cognitive brain function and any long-term changes in brain function secondary to injury should cause a change in the parameters of the PLR. We performed a retrospective clinical review of the PLR of our patients using the BrightLamp Reflex iPhone app. The PLR variables of latency, maximum pupil diameter (MaxPD), minimum pupil diameter (MinPD), maximum constriction velocity (MCV), and the 75% recovery time (75% PRT) were associated with significant differences between subjects who had suffered a concussion and those that had not. There were also significant differences in PLR metrics over the life span and between genders and those subjects with and without symptoms. The differences in PLR metrics are modulated not only by concussion history but also by gender and whether or not the person has symptoms associated with a head injury. A concussive injury to the brain is associated with changes in the PLR that persist over the life span, representing biomarkers that might be used in clinical diagnosis, treatment, and decision making.
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Affiliation(s)
- Frederick Robert Carrick
- College of Medicine, University of Central Florida, Orlando, FL 32816, USA;
- Burnett School of Biomedical Science, University of Central Florida, Orlando, FL 32816, USA
- MGH Institute for Health Professions, Boston, MA 02129, USA
- Centre for Mental Health Research in Association with University of Cambridge, Cambridge CB2 1TN, UK
- Carrick Institute, Cape Canaveral, FL 32920, USA; (S.F.A.); (M.H.); (G.P.); (E.O.)
- Correspondence:
| | - Sergio F. Azzolino
- Carrick Institute, Cape Canaveral, FL 32920, USA; (S.F.A.); (M.H.); (G.P.); (E.O.)
| | - Melissa Hunfalvay
- Carrick Institute, Cape Canaveral, FL 32920, USA; (S.F.A.); (M.H.); (G.P.); (E.O.)
| | - Guido Pagnacco
- Carrick Institute, Cape Canaveral, FL 32920, USA; (S.F.A.); (M.H.); (G.P.); (E.O.)
- Department of Electrical and Computer Engineering, University of Wyoming, Laramie, WY 82071, USA
| | - Elena Oggero
- Carrick Institute, Cape Canaveral, FL 32920, USA; (S.F.A.); (M.H.); (G.P.); (E.O.)
- Department of Electrical and Computer Engineering, University of Wyoming, Laramie, WY 82071, USA
| | - Ryan C. N. D’Arcy
- BrainNET, Health and Technology District, Vancouver, BC V3V 0C6, Canada;
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC V3V 0C6, Canada
- DM Centre for Brain Health, Department of Radiology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Mahera Abdulrahman
- Health Informatics and Smart Health Department, Health Regulation Sector, Dubai Health Authority, Dubai 7272, United Arab Emirates;
| | - Kiminobu Sugaya
- College of Medicine, University of Central Florida, Orlando, FL 32816, USA;
- Burnett School of Biomedical Science, University of Central Florida, Orlando, FL 32816, USA
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