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Uveomeningoencephalitic Syndrome (Vogt-Koyanagi-Harada)

Uveomeningoencephalitic Syndrome (Vogt-Koyanagi-Harada) Abstract UVEOMENINGOENCEPHALITIC syndrome (Vogt-Koyanagi-Haranda [VKH]) is an unusual syndrome with important neurological complications and has not, to my knowledge, been discussed in English in the neurological literature. VKH is a multisystem disorder and includes idiopathic uveitis, dysacousia, leukodermia, alopecia, canities (whitened hair), poliosis (whitened eyebrows and eyelashes), acute encephalitic signs, and fluctuating meningeal symptoms both central and peripheral. The syndrome has been described only in ophthalmological journals, save for a few recent dermatologic and otolaryngologic reports and papers scattered in foreign journals. The neurological aspects of the syndrome have become appreciated only gradually, which Walsh (1957)34 has summarized in his neuroophthalmology text. Reed et al (1958)26 called attention to the problem of differentiating VKH from other acute brain disorders requiring craniotomy, particularly when the intracranial pressure was increased. In this report the clinical features of the syndrome will be surveyed, and two cases focusing on neurological aspects will References 1. Frances V. Henry, PhD, Audiologist and Speech Pathologist, Cincinnati Children's Hospital. 2. Leon Goldman, MD, Professor of Dermatology. 3. Alan Freemond, MD, Associate Professor of Ophthalmology; Donald J. Lyle, MD, Professor of Ophthalmology. 4. Theodore Wohl, PhD, Associate Professor of Psychology. 5. Emile Werk, Jr., MD, Associate Professor of Medicine. 6. Alajouanine, T., et al: Meningoencephalitis With Unilateral Uveitis and Retinal Detachment Following Recurrent Icterogenic Hepatitis: Confusional Syndrome Persisting for Six Months With Ventricular Dilation and CSF Changes , Rev Neurol 89:281-287, 1953. 7. Baumal, A.: Vogt-Koyanagi Syndrome: Poliosis, Alopecia, Bilateral Uveitis, Vitiligo, Dysacousia , Arch Derm 85:416-417, 1962. 8. Cambiaggi, A.: Hallerman-Streiff Syndrome (Mandibulo-Facial Dysostosis) With Fuch's Heterochromia , Boll Oculist 37:365-374, 1958. 9. Cantat, G., and Rouher, F.: Electroencephalography and Cerebral Fluid in Uveo-Meningitis and Uveitis , Bull Soc Ophthal Franc 7-8:595-600, 1958. 10. Carrasquillo, H. F.: Uveitis With Poliosis, Vitiligo, Alopecia, and Dysacousia (Vogt-Koyanagi Syndrome) , Arch Ophthal 28:385-414, 1942.Crossref 11. Cowper, A. R.: Harada's Disease and Vogt-Koyanagi Syndrome: Uveo-Encephalitis , Arch Ophthal 45:367-376, 1951.Crossref 12. Duke-Elder, W. S.: Textbook of Ophthalmology , St. Louis: C. V. Mosby, 1941, 1952, Vol 3, 5. 13. Erbakan, S.: Harada's Disease: First Case Reported in Turkey , Amer J Ophthal 53:368-371, 1962. 14. Forlani, D.: Opticochiasmal Neuritis in Meningo-Uveitis , Riv Otoneurooftal 34:18-30, 1959. 15. Franceschetti, A., and Maeder, G.: Facial Hemiatrophy With Alopecia (Romberg's Syndrome) Associated With Heterochromic Cyclitis (Fuch's Syndrome) , J Genet Hum 7:116-120, 1958. 16. Garcin, R.: Multiple Sclerosis With Uveoneuritis , Laval Med 26:522-554, 1958. 17. Haar, M.: Uveitis With Neurological Symptoms , Acta Ophthal (Kobenhaven) 39:60-70, 1961.Crossref 18. Hager, G.: Sympathetic Ophthalmitis, Vogt-Koyanagi's Syndrome and Harada's Disease , Klin Mbl Augenheilk 131:89-100, 1957. 19. Harada, E.: Beitrage zur klinischen Kernitis von nichteitriger Choroiditis , Acta Soc Ophthal Jap 30:356-361, 1926. 20. Jess, A.: Poliosis, Vitiligo, und doppelseitige schwerste Iridocyclitic bei Dystrophia Adiposo-Genitalis , Ber Deutsh Ophthal Ges 49:469-473, 1932. 21. Kastnelson, A. B.: Harada's Disease: Uveomeningeal Syndrome , Zh Oftal 4:229-234, 1958. 22. Koyanagi, Y.: Dysakusis, Alopecia und Poliosis bei schwerer Uveitis nichttraumitischen Ursprunges , Klin Mbl Augenheilk 82:194-211, 1929. 23. Lewis, G. M., and Esplin, B. M.: Vogt-Koyanagi Syndrome , Arch Derm Syph 59:526-530, 1949.Crossref 24. Leyva, A. V.: Uveo-Meningitis, Uveo-Encephalitis: Vogt-Koyanagi-Harada Syndrome: Intra-Cranial Pseudo Hypertension: Report of Three Cases , Arch Hosp Univ (Habana) 11:215-231, 1959. 25. Ludwig, A., and Korting, G.: Vogt-Koyanagi-Like Syndrome and Mandibulo-Facial Dystosis (Franceschetti-Zwalen Syndrome) , Arch Derm Syph (Berlin) 190:307-314, 1950.Crossref 26. Monnet, P.; Saint-Pierre, A.; and Gailot, M.: Infantile Encephalopathy With Uveo-Meningo-Encephalitis; Are Viruses Supposed to Be Responsible for Uveo-Meningo-Encephalitis Likely to Cause Foetal Anomalies , Nourisson 46:246-249, 1958. 27. Moreau, P. G.: Heerfordt's Syndrome and Meningeal Encephalitic Manifestations , Bull Soc Ophthal Franc 3:243-245, 1958. 28. Parker, W. R.: Uveitis Associated With Alopecia, Poliosis, Vitiligo, and Deafness: Report of Two Cases , Arch Ophthal 14:577-581, 1931. 29. Pattison, E. M., and Henry, F. V.: Audiologic Responses in Uveo-Meningo-Encephalitic Syndrome, to be published. 30. Pinero, A., and Gimenez, R.: Vogt-Koyanagi Syndrome: Case in Fröhlich Constitutional Type , Arch Soc Oftal Hisp Amer 12:1402-1406, 1952. 31. Reed, H., et al: Uveo-Encephalitic Syndrome of Vogt-Koyanagi-Harada Disease , Canad Med Ass J 79:451-459, 1958. 32. Samuelly, C.: Importance of Neuro-Vegetative System in Vogt-Koyanagi-Harada Syndrome , Arch Ottal 59:524-533, 1955. 33. Schlaegel, T. F., Jr., and Hoyt, M.: Psychosomatic Ophthalmology , Baltimore: The Williams and Wilkins Company, 1957. 34. Stevens, H.: Cogan's Syndrome , AMA Arch Neurol Psychiat 71:337-343, 1954.Crossref 35. Sugiera, S.; Fukuda, M.; and Eda, K.: Viral Nature of Vogt-Koyanagi-Harada Syndrome , Acta Soc Ophthal Jap 57:117-126, 1953. 36. Swartz, E. A.: Vogt-Koyanagi Syndrome, Precipitated by Lens Extraction , Amer J Ophthal 39:488499, 1955. 37. Tarab, S.: Vogt-Koyanagi Syndrome Associatea With Klippel-Feil Syndrome, Agenesia of Ear, and Other Malformations , Confin Neurol 16:243-247, 1956.Crossref 38. Vogt, A.: Fruhzeitiges ergrauen der Cilien und bemerkungen uber densogenannten plotzlichen Eintritt dieser Veranderung , Klin Mbl Augenheilk 44:228-242, 1906. 39. Walsh, F. B.: Clinical Neuro-Ophthalmology , ea 2, Baltimore: The Williams and Wilkins Company, 1957. 40. Woods, A. C.: Endogenous Uveitis , Baltimore: The Williams and Wilkins Company, 1958. 41. Yoshida, E.: Experimental Studies in Pathogenesis of Idiopathic Uveitis (Uveo-Encephalitis): II . Acta Soc Ophthal Jap 61:1211-1220, 1957. 42. Zamorani, G.: Neuro-Panuveitic Syndromes , Boll Oculist 38:846-852, 1959. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Uveomeningoencephalitic Syndrome (Vogt-Koyanagi-Harada)

Archives of Neurology , Volume 12 (2) – Feb 1, 1965

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Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1965.00460260087010
Publisher site
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Abstract

Abstract UVEOMENINGOENCEPHALITIC syndrome (Vogt-Koyanagi-Haranda [VKH]) is an unusual syndrome with important neurological complications and has not, to my knowledge, been discussed in English in the neurological literature. VKH is a multisystem disorder and includes idiopathic uveitis, dysacousia, leukodermia, alopecia, canities (whitened hair), poliosis (whitened eyebrows and eyelashes), acute encephalitic signs, and fluctuating meningeal symptoms both central and peripheral. The syndrome has been described only in ophthalmological journals, save for a few recent dermatologic and otolaryngologic reports and papers scattered in foreign journals. The neurological aspects of the syndrome have become appreciated only gradually, which Walsh (1957)34 has summarized in his neuroophthalmology text. Reed et al (1958)26 called attention to the problem of differentiating VKH from other acute brain disorders requiring craniotomy, particularly when the intracranial pressure was increased. In this report the clinical features of the syndrome will be surveyed, and two cases focusing on neurological aspects will References 1. Frances V. Henry, PhD, Audiologist and Speech Pathologist, Cincinnati Children's Hospital. 2. Leon Goldman, MD, Professor of Dermatology. 3. Alan Freemond, MD, Associate Professor of Ophthalmology; Donald J. Lyle, MD, Professor of Ophthalmology. 4. Theodore Wohl, PhD, Associate Professor of Psychology. 5. Emile Werk, Jr., MD, Associate Professor of Medicine. 6. Alajouanine, T., et al: Meningoencephalitis With Unilateral Uveitis and Retinal Detachment Following Recurrent Icterogenic Hepatitis: Confusional Syndrome Persisting for Six Months With Ventricular Dilation and CSF Changes , Rev Neurol 89:281-287, 1953. 7. Baumal, A.: Vogt-Koyanagi Syndrome: Poliosis, Alopecia, Bilateral Uveitis, Vitiligo, Dysacousia , Arch Derm 85:416-417, 1962. 8. Cambiaggi, A.: Hallerman-Streiff Syndrome (Mandibulo-Facial Dysostosis) With Fuch's Heterochromia , Boll Oculist 37:365-374, 1958. 9. Cantat, G., and Rouher, F.: Electroencephalography and Cerebral Fluid in Uveo-Meningitis and Uveitis , Bull Soc Ophthal Franc 7-8:595-600, 1958. 10. Carrasquillo, H. F.: Uveitis With Poliosis, Vitiligo, Alopecia, and Dysacousia (Vogt-Koyanagi Syndrome) , Arch Ophthal 28:385-414, 1942.Crossref 11. Cowper, A. R.: Harada's Disease and Vogt-Koyanagi Syndrome: Uveo-Encephalitis , Arch Ophthal 45:367-376, 1951.Crossref 12. Duke-Elder, W. S.: Textbook of Ophthalmology , St. Louis: C. V. Mosby, 1941, 1952, Vol 3, 5. 13. Erbakan, S.: Harada's Disease: First Case Reported in Turkey , Amer J Ophthal 53:368-371, 1962. 14. Forlani, D.: Opticochiasmal Neuritis in Meningo-Uveitis , Riv Otoneurooftal 34:18-30, 1959. 15. Franceschetti, A., and Maeder, G.: Facial Hemiatrophy With Alopecia (Romberg's Syndrome) Associated With Heterochromic Cyclitis (Fuch's Syndrome) , J Genet Hum 7:116-120, 1958. 16. Garcin, R.: Multiple Sclerosis With Uveoneuritis , Laval Med 26:522-554, 1958. 17. Haar, M.: Uveitis With Neurological Symptoms , Acta Ophthal (Kobenhaven) 39:60-70, 1961.Crossref 18. Hager, G.: Sympathetic Ophthalmitis, Vogt-Koyanagi's Syndrome and Harada's Disease , Klin Mbl Augenheilk 131:89-100, 1957. 19. Harada, E.: Beitrage zur klinischen Kernitis von nichteitriger Choroiditis , Acta Soc Ophthal Jap 30:356-361, 1926. 20. Jess, A.: Poliosis, Vitiligo, und doppelseitige schwerste Iridocyclitic bei Dystrophia Adiposo-Genitalis , Ber Deutsh Ophthal Ges 49:469-473, 1932. 21. Kastnelson, A. B.: Harada's Disease: Uveomeningeal Syndrome , Zh Oftal 4:229-234, 1958. 22. Koyanagi, Y.: Dysakusis, Alopecia und Poliosis bei schwerer Uveitis nichttraumitischen Ursprunges , Klin Mbl Augenheilk 82:194-211, 1929. 23. Lewis, G. M., and Esplin, B. M.: Vogt-Koyanagi Syndrome , Arch Derm Syph 59:526-530, 1949.Crossref 24. Leyva, A. V.: Uveo-Meningitis, Uveo-Encephalitis: Vogt-Koyanagi-Harada Syndrome: Intra-Cranial Pseudo Hypertension: Report of Three Cases , Arch Hosp Univ (Habana) 11:215-231, 1959. 25. Ludwig, A., and Korting, G.: Vogt-Koyanagi-Like Syndrome and Mandibulo-Facial Dystosis (Franceschetti-Zwalen Syndrome) , Arch Derm Syph (Berlin) 190:307-314, 1950.Crossref 26. Monnet, P.; Saint-Pierre, A.; and Gailot, M.: Infantile Encephalopathy With Uveo-Meningo-Encephalitis; Are Viruses Supposed to Be Responsible for Uveo-Meningo-Encephalitis Likely to Cause Foetal Anomalies , Nourisson 46:246-249, 1958. 27. Moreau, P. G.: Heerfordt's Syndrome and Meningeal Encephalitic Manifestations , Bull Soc Ophthal Franc 3:243-245, 1958. 28. Parker, W. R.: Uveitis Associated With Alopecia, Poliosis, Vitiligo, and Deafness: Report of Two Cases , Arch Ophthal 14:577-581, 1931. 29. Pattison, E. M., and Henry, F. V.: Audiologic Responses in Uveo-Meningo-Encephalitic Syndrome, to be published. 30. Pinero, A., and Gimenez, R.: Vogt-Koyanagi Syndrome: Case in Fröhlich Constitutional Type , Arch Soc Oftal Hisp Amer 12:1402-1406, 1952. 31. Reed, H., et al: Uveo-Encephalitic Syndrome of Vogt-Koyanagi-Harada Disease , Canad Med Ass J 79:451-459, 1958. 32. Samuelly, C.: Importance of Neuro-Vegetative System in Vogt-Koyanagi-Harada Syndrome , Arch Ottal 59:524-533, 1955. 33. Schlaegel, T. F., Jr., and Hoyt, M.: Psychosomatic Ophthalmology , Baltimore: The Williams and Wilkins Company, 1957. 34. Stevens, H.: Cogan's Syndrome , AMA Arch Neurol Psychiat 71:337-343, 1954.Crossref 35. Sugiera, S.; Fukuda, M.; and Eda, K.: Viral Nature of Vogt-Koyanagi-Harada Syndrome , Acta Soc Ophthal Jap 57:117-126, 1953. 36. Swartz, E. A.: Vogt-Koyanagi Syndrome, Precipitated by Lens Extraction , Amer J Ophthal 39:488499, 1955. 37. Tarab, S.: Vogt-Koyanagi Syndrome Associatea With Klippel-Feil Syndrome, Agenesia of Ear, and Other Malformations , Confin Neurol 16:243-247, 1956.Crossref 38. Vogt, A.: Fruhzeitiges ergrauen der Cilien und bemerkungen uber densogenannten plotzlichen Eintritt dieser Veranderung , Klin Mbl Augenheilk 44:228-242, 1906. 39. Walsh, F. B.: Clinical Neuro-Ophthalmology , ea 2, Baltimore: The Williams and Wilkins Company, 1957. 40. Woods, A. C.: Endogenous Uveitis , Baltimore: The Williams and Wilkins Company, 1958. 41. Yoshida, E.: Experimental Studies in Pathogenesis of Idiopathic Uveitis (Uveo-Encephalitis): II . Acta Soc Ophthal Jap 61:1211-1220, 1957. 42. Zamorani, G.: Neuro-Panuveitic Syndromes , Boll Oculist 38:846-852, 1959.

Journal

Archives of NeurologyAmerican Medical Association

Published: Feb 1, 1965

References