So Moon Unit has been going through a few medical things.
She had a brain MRI done recently, which luckily turned up no structural issues (she’s been having what appear to be short seizures; since confirmed via EEG).
BUT, there was a note saying that there was an image “strongly suggestive of a staphyloma in the maxillary sinus”. And the word “calcified” was used.
We just assumed this meant that she had a sinus infection at some point and there was basically a small calcified bit of infection… as I assumed it referred to staphylococcus, and of course “maxillary sinus”. The neurologist even said it was something that could be treated with a laser, which also seemed like something sinus-related.
Doctor Google disagrees - and says it’s something to do with the eye. Hint: do NOT google images for this; some can be pretty pretty squicky looking. It can be correlated with severe nearsightedness (she’s more nearsighted than I am but not as bad as her father). I can’t find anything talking about it having anything to do with the sinuses.
Yet, the doctor was very clear that this was an eye issue (she called us back later to make sure we understood that) not a sinus issue.
The sinuses are right next to the orbital socket. Staphyloma is a bulge of eye material or blood vessels. Presumably, Moon Unit’s staphyloma is bulging in or towards or near her sinuses.
I wouldn’t freak out, if it’s treatable. It’s worth asking if they think it’s going to recur. I would also ask if they think this is causing the seizures, through muscle or blood vessel contractions or if the staphyloma is a result of the seizures. It might be “neither”, of course.
Good point on asking whether there might be a connection to the seizures.
Everything I can find on this sort of thing seems to suggest that it’s either due to an injury or similar (and visible from the front), or it’s “posterior” and strongly linked to pathologic myopia. The kid’s nearsighted, but not THAT bad (her vision is worse than mine but better than her father’s).
There’s not a lot out there about how it’s treated or whether it really causes any problems.
Evidently, the way the doctor repeated the MRI info was garbled: the staphyloma is separate from the sinus issue (which makes sense as something like what I imagined would seem to make it impossible to move her eyeball at all).
No, the sinus opacity is just (per an ENT) just a buildup of mucus (not calcified though that could happen). She probably needs sinus surgery to sort that out and fix a deviated septum, but that’s not urgent.
The ophthalmologist either saw no evidence of a staphyloma, or didn’t think it was significant (Moon Unit is 21 and went to see him by herself). He did say something about a buildup of spinal fluid behind her eye and that she’d need a spinal tap… evidently he said nothing more than that - and when I made her call him to ask “what’s the significance and is this urgent?” he basically refused to answer, as “that’s for the neurologist”. Argh.
And she had an appointment with the neurologist this morning for that very reason… but the neuro WAS NOT THERE (had been injured) and she just saw the assistant, who had no clue and couldn’t even give her prescription updates. In other words, they scheduled an appointment, and did not bother to call her to tell her not to come.
So right now we don’t know whether the kid’s head is about to explode, or what…
Also, the root Staphyl means grape. In staphylococcus it’s because the cluster of bacterial cells look like a bunch of gapes (https://goo.gl/images/jnJhEG) under the microscope. In Staphyloma, the protrusion looks gapelike.
We are in the process of packing her up to go live at a facility in rural Vermont for a few months… like, we’re leaving in 12 hours - and don’t know whether we need to look the places over, say “cool, see ya in 3 weeks” and bring her back, or leave her there. A lot will depend on whether we can get hold of the neurologist by phone next week to get her take on things.
I’m sorry, I don’t know anything about this. I saw your post and just wanted to pop in and say I hope your daughter is ok. Please let us know how she is and that you are also doing ok.
I finally, late last week, got thirdhand word from the neuro that “it’s nothing to worry about”. I have some questions about that neuro’s qualifications - she’s given my daughter appropriate treatment but she’s not board-certified and her office is very badly run - and I want her watched by someone closer to where she is, so we’ll likely do at least some followup up there.
Never got any further info from the ophthalmologist (beyond “no staphyloma”). I see a different eye doc who used to be in practice with him - when they split up my husband went with this guy while I stayed with mine. So I took a copy of the report when I saw my eye doc a few weeks back and asked if she could translate it. Her first words were “Dr. so-and-so has a bad bedside manner” which cracked me up, as my husband had said the same.
She said much the same as he did though, and did suggest a followup with a neuro. She suggested we might want a specific specialist (neuro-opthalmology) though those are quite rare.
Later on she mentioned, in an “aha!” moment, that Moon Unit’s findings might be due to a benign hereditary condition (that I have, but neither Moon Unit nor the other doc was aware of). But still a good idea to get a second opinion.
I finally pried loose her records from the local neuro, so we’ll have that as well as the writeup from the eye doc. We’re debating making a trip up there and taking her over to Dartmouth for a couple of days, as that’s the closest place that handles zebra-ish conditions.
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