title: Susac syndrome: diverse clinical findings and treatment.
abstract: We report a case of a 19-year-old woman presenting bilateral neurosensorial hearing loss, mental abnormalities, and loss of visual field in the left eye. Visual acuity was 20/20 in OD and 20/25 in OS. Patient was examined systemically. Audiometry showed sensorineural hearing loss in both ears. The magnetic resonance imaging (MRI) of brain revealed multiple small lesions in the white matter in both cerebral hemispheres and at the corpus callosum. Fundoscopy showed bilateral normal optic disc and sheathing of the arterioles in the middle periphery of OD. Retinal edema and cotton-wool spots were observed. Fluorescein angiography showed bilateral peripheral occlusive arterial vasculopathy. The patient was diagnosed with Susac syndrome and treated with quetiapine fumarate, flunitrazepam, and prednisone, which resulted in stabile outcome. This case shows that a high index of suspicion leading to early recognition and treatment is important to avoid irreversible damage.
authors.affiliation: Department of Ophthalmology, Hospital Evangélico, Curitiba, PR, Brazil.
authors.forename: Ricardo Canto
authors.initials: RC
authors.lastname: Bardal
authors.affiliation: Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Emmerson
authors.initials: E
authors.lastname: Badaro
authors.affiliation: Paraná Eye Hospital, Curitiba, PR, Brazil.
authors.forename: Jayme
authors.initials: J
authors.lastname: Arana
authors.affiliation: Paraná Eye Hospital, Curitiba, PR, Brazil.
authors.forename: Fabio
authors.initials: F
authors.lastname: Alves
authors.affiliation: Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Eduardo Cunha de
authors.initials: EC
authors.lastname: Souza
authors.affiliation: Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Pedro Paulo
authors.initials: PP
authors.lastname: Bonomo
authors.affiliation: Paraná Eye Hospital, Curitiba, PR, Brazil.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Portella
authors.affiliation: Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Maia
mesh_terms: D001299:Audiometry; D005260:Female; D005451:Fluorescein Angiography; D006312:Hearing Loss, Bilateral / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D055955:Susac Syndrome / Q000188:drug therapy* / Q000473:pathology* / Q000503:physiopathology; D014792:Visual Acuity; D055815:Young Adult