Ocular Flutter: A Rare Case

REPORTtransaminase (55 U/L), alanine aminotransferase (234 U/L), and alkaline phosphatase (ALP) (327 U/L), with normal total protein (7.1 g/dL) and albumin levels (3.96 g/dL).Renal function tests were normal.Blood and urine cultures showed no growth.Serum testing for HBsAg, anti-HAV, anti-HCV, HIV-1 ,2, anti-HEV dengue, leptospira, and scrub typhus serology was negative.EBV [Viral Capsid Antigen (VCA)] IgM chorus by Immunoshop was positive with an index value of 3.7, and negative for IgM CMV antibodies.Antitissue transglutaminase immunoglobulin A (anti-TTG IgA) (0.4 U/mL) and blood lead levels (3.5 g/dL) were found to be normal.Extensive cancer screening tests, including abdominal ultrasound, chest and abdomen computed tomography (CT) scans, and a full-body positron emission tomography (PET) scan, showed no evidence of tumors or malignancy.The contrastenhanced magnetic resonance imaging (MRI) brain did not reveal significant changes (Figs 1 to 4).Cerebrospinal fluid (CSF) examination showed two cells, a protein level of 45 mg/dL, a glucose level of 56 mg/dL, and positive EBV polymerase chain reaction (PCR).History, examination, and investigation confirmed the diagnosis of EBV viral hepatitis and isolated ocular flutter.He was administered methylprednisolone steroid pulse (1 gm) daily for 5 days, following which he improved dramatically.Liver function tests done at this point showed a decline in liver 1-