Question

Patient Scenario:

Ms. Snow, age 39, presents to an ophthalmologist with a complaint of double vision and decreased facial affect (ability to display emotion). She is employed full-time in a relatively sedentary job but with regular stressful periods (projects and such). Her symptoms are noticeably worse later in the day or during periods of stress. She is in good physical condition. The ophthalmologist takes a medical history and physical and neurological examination and orders a test of the patient’s thyroid in addition to routine diagnostic tests. Test results are normal and the patient is sent home with a referal to an optometrist.

Research Ms. Snow’s symptoms and determine a differential diagnosis by listing at least two different possible conditions that match some or all of Ms. Snow’s symptoms. Justify why you selected each of the conditions on your list. Write a detailed answer to the discussion question. Your post must be at least 3-4 sentences per differential diagnosis.

Answer 1

1 myesthenia gravis-- caused by an error in the transmission of nerve impulses to muscles .here the antibodies block or alter the receptors of acetylecholine at the neuromuscular junction prevents muscle from contracting .ocular ,facial and neck muscle involvement is common one of preliminary symptom is double vision but pupils are spared.emotional stress exaggerate the symptoms .assay for anti -AChr and anti-MuSK ANTIBODIES ,CT OR MRI OF THYMUS ARE CONFIRMATORY

2 BLEPHAROSPASM CAUSED BY ABNORMAL BRAIN FUNCTION IN THE PART OF BRAIN THAT CONTROLS MUSCLES SYMPTOMS TRIGGERED BY STRESS AND BEING OVERLY TIRED .SYMPTOMS ARE GRADUAL INCREASE IN EYE IRRITATION AND BLINKING .AS THE CONDITION PROGRESS SYMPTOM BECOME MORE FREQUENT AND FACIAL SPASM DEVELOP .DIAGNOSIS BY CLINICAL EVALUATION ELECTRODIAGNOSIS IS AN IMPORTANT TOOL