Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028738 (nystagmus)
 7,431 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The orthopaedic surgeon is often the first consultant to whom a patient with syringomyelia is referred. The disease is not as rare as he may suppose, but its early presenting features are very variable; if he relies solely on such familiar features as pes cavus and scoliosis, he may well miss the diagnosis. The commonest presenting symptom is pain in the head, neck, trunk or limbs; headache or neckache made worse by straining is particularly significant. A history of birth injury also may suggest the possibility of syringomyelia, especially if any spasticity subsequently worsens. Neurological features which may be diagnostic include nystagmus, dissociated sensory loss, muscle wasting, spasticity of the lower limbs or Charcot's joints. Radiographic features include erosion of the bodies of cervical vertebrae and widening of the spinal canal; if, at C5, the size of the canal exceeds that of the body by 6 millimetres in the adult, pathological dilatation is present. The presence of basilar invagination or other abnormalities of the foramen magnum, of spina bifida occulta and of scoliosis are further pointers. Thermography is a useful way of showing asymmetrical sympathetic involvement in early cases. A greater awareness of the prevalence of syringomyelia may lead to earlier diagnosis and to early operation, which appears to hold out the best hope of arresting what is all too commonly a severely disabling and progressive condition.
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PMID:Orthopaedic features in the presentation of syringomyelia. 15 24

Thirty-six patients with benign intracranial hypertension (BIH) were reviewed. Follow-up was obtained on 33 patients (91%) after a mean period of 7 1/2 years. Precipitating factors were found in 27 patients (75%). On admission, 5 patients had retro-ocular pain, especially on eye movements, a complaint not yet described in BIH. Seven patients had nystagmus, two of them horizontal positional nystagmus. It is questionable whether all signs in BIH are caused by the raised CSF pressure. The general outcome was good. Only two patients sustained severe ultimate visual impairment. Both presented with retro-ocular pain and sudden loss of vision on admission. Papilloedema can persist for years in BIH without serious visual impairment. Sometimes "causal" treatment is possible. No symptomatic treatment which is free from complications has been proved to prevent visual failure.
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PMID:Benign intracranial hypertension. A retrospective and follow-up study. 43 Jan

Eye care professionals can play an important role in the early detection of multiple sclerosis (MS) since the disease often has ocular manifestations such as optic neuritis. In conjunction with optic neuritis, symptoms such as ocular pain, acuity reduction, visual field loss, blurred or edematous discs, nystagmus, and diplopia may be present. Although MS still has no cure, early identification can aid in beginning the treatment of the symptoms.
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PMID:Early identification of multiple sclerosis through ocularly manifested symptoms. 45 99

A 38-year-old man developed pain and peripheral-type weakness on the right side of his face and was discovered to have decreased hearing bilaterally, as well as optic nerve swelling on the right. The pain and optic nerve swelling subsided over a period of six weeks, but hearing loss and facial weakness persisted. Thirty months later, he developed dysphagia, ataxia, dysarthria, nystagmus, and progressive spastic quadriparesis. He died approximately four years after the onset of the illness. Although no evidence of disease was found other than in the central nervous system during life, two nodules in the right lower lung were found on autopsy. The examination of these nodules, as well as the brain stem, showed an angiocentric and angionecrotic process with lymphoreticular and plasmacytoid invasion.
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PMID:Lymphomatoid granulomatosis clinically confined to the CNS. A case report. 58 1

The characteristic clinical features and morphological findings of five cases of (clinically not diagnosed) fusiform aneurysm of the basilar or vertebral arteries were recurring attacks of positional occipital headache, pain and stiffness in the neck, cranial nerve disturbances, expecially oculomotor palsies and anisokoria, nystagmus, attacks of nausea, vomiting and sweating, tachycardia, pyramidal tract symptoms, and pareses. Severe hypertension had been present in four instances. The aneurysm, which is usually thrombosed, pressed against the pons and medulla oblongata as a space-occupying mass. In addition to hypertension and atheromatosis, congenital defect in the arterial wall are probably significant causative factor. To mistake an aneurysm for a cervical syndrome may be fatal to the patient.
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PMID:[Basilar or vertebral artery aneurysm as a cause of presumed cervical spine injury (author's transl)]. 63 Oct 51

The clinical findings in a group of 32 rheumatoid patients with symptomatic myelopathy are described. The myelopathy appeared in late middle age after many years of rheumatoid disease (average duration, 18 years). The most common radiological abnormality was anterior subluxation of C1. Other patterns occurred in about half the cases. The most common neurological findings were those of a mild to moderate spastic paraplegia, often with atrophy of muscles of the hands and sensory changes in the hands. Symptoms originating above the foramen magnum (nystagmus, diplopia, slurred speech) appeared to have a vascular cause and were sometimes associated with upward as well as posterior movement of the odontoid process. Root pain into the arms was not present, and its absence helped to distinguish these disorders from cervical spondylosis. Root pain into the territory of the C2 root was common. Medical or conservative therapy was not effective, and the preferred approach was use of a halo traction device followed by posterior fusion, with or without laminectomy. Pathologically, in 2 autopsy cases, the maximal change had occurred in the central gray matter and adjacent posterior and lateral columns. We postulate that direct pressure caused intermittent compression and narrowing of distal transverse branches of the anterior spinal artery.
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PMID:The cervical myelopathy associated with rheumatoid arthritis: analysis of patients, with 2 postmortem cases. 65 64

An acute progressive CNS disease characterized by fever, nystagmus, head tilt, facial paralysis, circling, and cervical pain was studied in 6 mature dogs. The term "granulomatous meningoencephalomyelitis" was proposed for the disease complex, which was characterized pathologically by disseminated granulomatous lesions having a predilection for brainstem structures.
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PMID:Granulomatous meningoencephalomyelitis in six dogs. 65 1

To evaluate the role of reflexes related to the lumbar proprioceptors in maintenance of body equilibrium, changes in equilibrium function of the eyes and body were observed after unilateral procainization of the lumbar erector muscles. Observations were made on normal subjects and vertigo cases with lumbar pain after whiplash injury using various equilibrium tests. The results obtained were as follows: (1) On unilateral procainization of the lumbar erector muscles of normal subjects, eye nystagmus and disturbances of the righting reflex developed. Simultaneously, changes in drift reactions of the lower limbs were detected by the stepping test. Namely, in many of the subjects examined the direction of stepping deviation became quite different from that before procainization, and stepping after procainization tended to show slight or moderate ataxic features, associated with a sensation of unsteadiness. (2) When procaine was injected unilaterally into tender spots in the lumbar erector muscles of traumatic vertigo cases, spontaneous eye nystagmus and disturbances of the righting reflex decreased. Simultaneously, significant changes in the drift reactions of the lower limbs were observed in many of the cases examined. Namely, the direction of deviation became the opposite of that before procainization and ataxia in walking almost disappeared with reduction in vertigo. The following conclusions were drawn from these findings: (1) The effects of procaine on equilibrium of normal subjects are in sharp contrast to its effects on equilibrium of traumatic vertigo cases. Findings in the former might be due to increased imbalance between the activities of the right and left lumbar proprioceptors, while those in the latter might be due to decreased imbalance between the two. (2) These findings support the view that from the standpoint of body equilibrium, there are two phases of the proprioceptive reflex, and that Fukuda's concept of "two phases of the labyrinthine reflex, i.e., a stage of disturbance and a stage of coordination", can be applied to interpretation of the proprioceptive reflex of lumbar origin.
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PMID:Lumbomuscular proprioceptive reflexes in body equilibrium. 105 19

In a prospective survey of 476 hospital in-patients with rheumatoid arthritis, vertical atlanto-axial subluxation (AAL) was found in 13 patients (3.7 per cent). All were women with severe rheumatoid arthritis. Neurological signs were found in ten patients, and in seven they appeared to be due to vertical AAL. The signs caused by vertical AAL were diminished pain and temperature sensation in the upper divisions of the trigeminal nerve, sensory loss in the areas supplied by C2, nystagmus and pyramidal lesions. Disabling involvement due to vertical AAL was not found although it may occur and the lesion may be fatal. The lower cervical spine was involved in all patients and severe lesions were seen in nine. The most severe neurological lesions appeared to be due to subaxial subluxation. Corticosteroid therapy may have been a contributing factor in four patients.
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PMID:Vertical atlanto-axial subluxation in rheumatoid arthritis. 112 36

Administering intravenous sedation in conjunction with intraoperative monitoring to cataract surgery patients is a widely accepted technique. Numerous articles report local sedation techniques for cataract surgery that are, in essence, abbreviated general anesthetic techniques for insertion of the retrobulbar block (RBB). Because of variations in levels of consciousness, a number of complications have been encountered with this specific patient population, ie, movement upon insertion of the RBB, intraoperative patient movement, confusion, hypotension, respiratory depression, and respiratory arrest. In an attempt to meet the specific needs of this patient population, a study comparing propofol-fentanyl with midazolam-fentanyl was initiated. Seventy-five (ASA 1 to 3) patients were randomly assigned to two groups: propofol-fentanyl (P/F) or midazolam-fentanyl (M/F). The mean age of patients in the P/F group was 71.1 +/- 13 SD, and the mean age in the M/F group was 74.4 +/- 8.8 SD. All patients entered the operating room unpremedicated. Before the RBB, patients in both groups were given a single intravenous dose of 50 micrograms fentanyl. Propofol (mean dose, 24.7 mg) or midazolam (mean dose, 1.58 mg) was then titrated to slurred speech or nystagmus. Patients' responses to the RBB were evaluated and recorded by an objective observer. The amnestic properties of both agents were evaluated by patient questioning at 10 minutes and 24 hours. Levels of discomfort were evaluated on a scale of 1 to 5, with 1 being extremely uncomfortable and 5 being noticeable without pain. Respiratory depressant effects of both techniques was assessed via continuous pulse oximetry. Results were analyzed using the chi 2 test, rank t test, and SD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Propofol-fentanyl versus midazolam-fentanyl: a comparative study of local sedation techniques for cataract surgery. 147 88


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