Studies have proven that more than 99% of all cases relating to Nelson Syndrome arise after a patient has had a bilateral adrenalectomy done for Cushing Disease (Chrousos, 25 Jul 2003). The single most common cause of the developing tumor with high levels of adrenocorticotropin or ACTH is primary adrenal insufficiency and this can either be congenital or acquired (Chrousos, 25 Jul 2003). The congenital cause includes hypoplasia or adrenal hyperplasia (Chrousos, 25 Jul 2003). The acquired c

A physical examination is done of patients with Nelson syndrome, which must include assessment of adequacy of steroid replacement, vision, cranial nerves and general skin pigmentation. During the examination, the height and weight are measured and vitals such as pulse and blood pressure are also measured. A formal ophthalmologic test is necessary. A thyroid examination is done to look for enlargements due to autoimmune hypothyroidism, hyperthyroidism, and hyper pigmentation (Chrousos, 25 Jul 2003). An abdominal test is done to look for liver disturbances (Chrousos, 25 Jul 2003). Other test includes pubertal staging, neurological examination and skin examination (Chrousos, 25 Jul 2003).

Patients suffering from Nelson syndrome also face visual disturbances. Loss of vision can also occur due to invasion of the visual apparatus by the tumor. Prechiasmatic lesions may affect the eyes and cause homonymous hemianopia (Aelveot, 605). The very first signs of vision disturbances would be visual loss in one eye or in one direction.

Nelson syndrome is a rare but complicated medical condition that causes the pituitary glands to dysfunction and cause a hormonal imbalan

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