Cases reported "Ophthalmoplegia"

Filter by keywords:



Filtering documents. Please wait...

1/483. Schwannoma in patients with isolated unilateral trochlear nerve palsy.

    PURPOSE: To describe the clinical features of patients with isolated unilateral trochlear nerve palsy secondary to imaging-defined schwannoma of the trochlear nerve. methods: A chart review of all patients seen at the Neuro-ophthalmology Unit at Emory University since 1989. Of 221 patients with trochlear nerve palsy, six had a lesion consistent with a trochlear nerve schwannoma. RESULTS: The six patients had isolated unilateral trochlear nerve palsy. Duration of diplopia before diagnosis averaged 6 months. magnetic resonance imaging demonstrated circumscribed, enhancing lesions along the cisternal course of the trochlear nerve, all measuring less than 5 mm in greatest dimension. Five of the patients were seen in follow-up, over periods ranging from 11 to 26 months from initial presentation (mean, 15.6 months; standard deviation, 6.0 months). All of these patients remained stable except one, who was slightly worse at 15 months by clinical measurements and magnetic resonance imaging. None of these patients have developed additional symptoms or signs of cranial nerve or central nervous system involvement. CONCLUSIONS: The differential diagnosis of an isolated unilateral fourth cranial nerve palsy should include an intrinsic neoplasm of the trochlear nerve. magnetic resonance imaging is useful, both for diagnosis and follow-up. These patients can remain stable and may not require neurosurgical intervention.
- - - - - - - - - -
ranking = 1
keywords = nerve
(Clic here for more details about this article)

2/483. Pituitary macroadenoma manifesting as an isolated fourth nerve palsy.

    PURPOSE: To describe an unusual ophthalmic manifestation of a pituitary adenoma. methods: Case report. RESULTS: A 32-year-old man had left supraorbital and frontal headaches and new-onset vertical diplopia. Examination showed a left fourth nerve palsy and increased vertical fusional amplitudes. magnetic resonance imaging disclosed a sellar mass consistent with a pituitary macroadenoma. CONCLUSION: A pituitary adenoma may rarely manifest with an isolated fourth nerve palsy.
- - - - - - - - - -
ranking = 0.46153846153846
keywords = nerve
(Clic here for more details about this article)

3/483. Fourth cranial nerve palsy in pediatric patients with pseudotumor cerebri.

    PURPOSE: To describe three children with acute fourth cranial nerve palsy secondary to pseudotumor cerebri. methods: We reviewed the medical records of children younger than 18 years who were diagnosed with pseudotumor cerebri between 1977 and 1997. pseudotumor cerebri was defined by normal neuro-imaging, elevated intracranial pressure measured by lumbar puncture, and normal cerebrospinal fluid composition. RESULTS: Three children with pseudotumor cerebri presented with vertical diplopia and clinical signs of fourth cranial nerve palsy including a hypertropia of the affected eye, which increased with adduction and ipsilateral head tilt. The fourth cranial nerve palsy resolved after reduction of the intracranial pressure in all three children. CONCLUSIONS: Fourth cranial nerve palsy may occur in children with pseudotumor cerebri and may be a nonspecific sign of elevated intracranial pressure.
- - - - - - - - - -
ranking = 0.61538461538462
keywords = nerve
(Clic here for more details about this article)

4/483. Tonic ocular tilt reaction simulating a superior oblique palsy: diagnostic confusion with the 3-step test.

    BACKGROUND: The tonic ocular tilt reaction (OTR) consists of vertical divergence of the eyes (skew deviation), bilateral conjugate ocular torsion, and paradoxical head tilt. The head and superior pole of both eyes are rotated toward the hypotropic eye. OBJECTIVE: To describe ocular motility and torsion findings in 5 patients with OTRs that mimicked superior oblique palsies (SOPs). RESULTS: In 5 patients, results of the 3-step test suggested an SOP (bilateral in 1 patient); however, no patient had the expected excyclotorsion of the hypertropic eye. Two patients had conjugate ocular torsion (intorsion of the hypertropic eye and extorsion of the hypotropic eye), and 2 patients had only intorsion of the hypertropic eye. All had other neurologic features consistent with more widespread brainstem disease. CONCLUSIONS: Vertical ocular deviations that 3-step to an SOP are not always caused by fourth nerve weakness. When a patient with an apparent fourth nerve palsy has ocular torsion that is inconsistent with an SOP, OTR should be suspected, especially if vestibular system or posterior fossa dysfunction coexists. The rules for the 3-step test for an SOP may be fulfilled by damaging the otolithic projections corresponding to projections of the contralateral anterior semicircular canal. Because results of the Bielschowsky head tilt test may be positive in patients with the OTR, the feature distinguishing OTR from an SOP is the direction of torsion. We advocate use of a fourth step-evaluation of ocular torsion-in addition to the standard 3 steps.
- - - - - - - - - -
ranking = 0.15384615384615
keywords = nerve
(Clic here for more details about this article)

5/483. Cerebral B-cell lymphoma following treatment for tolosa-hunt syndrome.

    We herein report a unique case of cerebral lymphoma which occurred after lymphocytic neuritis of cranial nerves causing tolosa-hunt syndrome and demonstrate the histological difference between these two diseases. A 70-year-old woman developed a sensory disturbance in the first and third divisions of the left trigeminal nerve and a left ocular movement disturbance five years before death. Although she was clinically diagnosed to have a schwannoma in the left cavernous sinus, a histologic examination verified a diffuse infiltration of T lymphocytes in the left trigeminal ganglion. Corticosteroid therapy was effective. Thereafter she demonstrated a disturbance of consciousness and dysphasia four years after surgery. A T1-weighted magnetic resonance image (MRI) disclosed high intensity lesions in both the basal ganglia and corpus callosum. She also showed progressive spastic paralysis. At autopsy a diagnosis of primary intracranial B-cell lymphoma was made. Although there was no invasion of the lymphoma cells into the left trigeminal nerves, a mild inflammatory infiltration of T cells still remained.
- - - - - - - - - -
ranking = 0.23076923076923
keywords = nerve
(Clic here for more details about this article)

6/483. The diagnosis of congenital unilateral third-nerve palsy.

    Sixteen cases of congenital unilateral third-nerve palsies collected from the records of the Wilmer eye Institute and The Johns Hopkins Hospital over twenty-one years are reviewed. Their aetiology, clinical features, differential diagnosis and prognosis are discussed. Their benign nature with respect to absence of associated neurological disease and the high probability of their causing amblyopia and aberrant regeneration are emphasized.
- - - - - - - - - -
ranking = 0.38461538461538
keywords = nerve
(Clic here for more details about this article)

7/483. Tolosa Hunt syndrome: a case report. Clinical and magnetic resonance imaging findings.

    A 36-year-old woman was admitted with a left abducens nerve palsy. MR showed enlargement of the left cavernous sinus. The patient was treated with 80 mg oral methyl prednisolone. Clinical findings improved within a month. Two months later, she was readmitted with left oculomotor and right abducens nerve palsy. MR showed significant increase in the volume of the abnormal area in the left cavernous sinus and a new lesion within the right cavernous sinus. After intravenous gadolinium dtpa, there was enhancement in both cavernous sinuses. Methyl prednisolone therapy was again started. After one month of treatment neurological examination was normal. Follow-up MR findings were similar to previous ones.
- - - - - - - - - -
ranking = 0.15384615384615
keywords = nerve
(Clic here for more details about this article)

8/483. The criteria of the International headache Society for tolosa-hunt syndrome need to be revised.

    In 1988 the International headache Society defined the diagnostic criteria of tolosa-hunt syndrome (THS) to include episode(s) of unilateral orbital pain for an average of 8 weeks if untreated, with associated paresis of one or more of the third, fourth, and sixth cranial nerves. Cranial nerve paresis may coincide with the onset of pain or follow it within a period of up to 2 weeks, and the pain must be relieved within 72 h after the initiation of corticosteroid therapy. Other causative lesions must be excluded by neuroimaging. On the basis of the history and neuroradiological findings of six patients we show the pitfalls in diagnosing THS with these criteria. We propose a revision of the criteria: Other causative lesions must be excluded by neuroimaging, especially of the region of the cavernous sinus and the orbita, and by blood and CSF examinations. Since imaging techniques have dramatically improved, it is now possible to visualize the inflammatory tissue in THS. Positive magnetic resonance imaging or computed tomography findings compatible with inflammatory tissue neither exclude nor confirm THS and remain suspect until a malignant tumor or inflammation other than THS is excluded. Clinical and radiological follow-up examinations must be performed for at least 2 years, even in patients with negative findings on magnetic resonance imaging at onset.
- - - - - - - - - -
ranking = 0.15384615384615
keywords = nerve
(Clic here for more details about this article)

9/483. Neuro-Behcet's disease presenting with isolated unilateral lateral rectus muscle palsy.

    The authors present the clinical findings of a 30-year-old female and a 29-year-old male who both had isolated unilateral lateral rectus muscle palsy in neuro-Behcet's disease. The clinical feature related to isolated abduscens nerve palsy was identified by CT, systemic assessment and extraocular examination. These patients' constellation of findings appear to be unique: it does not follow any previously reported pattern of ocular manifestations of neuro-Behcet's disease.
- - - - - - - - - -
ranking = 0.076923076923077
keywords = nerve
(Clic here for more details about this article)

10/483. Acute painful oculomotor nerve paresis caused by pituitary apoplexy--a case report.

    In a typical case of pituitary apoplexy, a patient, who may or may not be known to harbor a pituitary adenoma, suddenly develops a severe headache. The headache may be retro-orbital, frontal, frontotemporal, or diffuse and may be associated with neck stiffness, neck pain, or both. ophthalmoplegia may develop within a few hours after the onset of headache. Here we report a rare case of one middle-aged female with pituitary apoplexy initially presenting with acute onset of pupil-involved third cranial nerve palsy, headache and peri-ocular pain. Emergent neuroimaging revealed pituitary apoplexy and immediate intravenous corticosteroid was given and third nerve paresis was improved thereafter. Definite tumor removal was done smoothly after steroid treatment and complete recovery of ophthalmoplegia was noted 2 weeks after operation.
- - - - - - - - - -
ranking = 0.46153846153846
keywords = nerve
(Clic here for more details about this article)
| Next ->


Leave a message about 'Ophthalmoplegia'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.