Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0029089 (ophthalmoplegia)
 3,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with orbital aspergillosis commonly present with unilateral proptosis and associated sinus disease. However, neither of these manifestations was observed in a 62-year-old woman who had an orbital apex syndrome with visual loss, complete ophthalmoplegia, and corneal hypoesthesia. Pathologic examination of specimen from a granulomalike mass removed at left frontotemporal craniotomy showed branching hyphae with the characteristic appearance of Aspergillus.
 ...
PMID:Parasellar and orbital apex syndrome caused by aspergillosis. 94 65

The authors present an extremely rare case of aspergillosis of the central nervous system (CNS) causing subarachnoid hemorrhage (SAH). A 78-year-old female developed facial pain, progressive deterioration in left visual acuity, and left total ophthalmoplegia. Computed tomography demonstrated a heterogeneously enhanced mass extending from the sphenoid sinus to the left cavernous sinus and left orbit, and angiography showed luminal narrowing and irregularity of the left internal carotid artery at its siphon. Biopsy of the left orbital and sphenoid sinus mass resulted in the diagnosis of Aspergillus granuloma. Despite combined administration of amphotericin-B and 5-FC, she became comatose from brainstem infarction and finally, suddenly died. Postmortem examination revealed massive SAH due to a ruptured mycotic aneurysm of the basilar artery. Aspergillosis of the CNS is a growing problem with the wider use of immunosuppressants and antibiotics. To the authors' knowledge, however, only 13 cases of CNS aspergillosis causing SAH have been reported. The prognosis is absolutely bad, with all patients dying from rupture of major intracranial arteries such as the internal carotid artery and basilar artery. Early diagnosis and vigorous chemotherapy are important.
 ...
PMID:Aspergillosis of the central nervous system causing subarachnoid hemorrhage from mycotic aneurysm of the basilar artery--case report. 170 41

Invasive aspergillosis of the paranasal sinuses involving the orbit is termed sino-orbital aspergillosis. Prognosis of sino-orbital aspergillosis, complicated by impaired visual acuity and neurological signs, is disastrous and usually fatal. We herein report two patients with sino-orbital aspergillosis associated with total ophthalmoplegia. One patient was successfully treated with surgical eradication including orbital exenteration. In contrast, the other died of cerebral infarction, probably due to fungal thrombosis of the middle cerebral artery, despite repeated local debridement followed by orbital exenteration and administration of antifungal agents. Experience with these cases strongly indicates the necessity of prompt surgical eradication, including orbital exenteration if necessary, in the treatment of sino-orbital aspergillosis.
 ...
PMID:Sino-orbital aspergillosis associated with total ophthalmoplegia. 396 52

A man of 74 years of age, suffering from a left-sided ophthalmoplegia and a radiologically detected opacification of the sphenoid sinus with destruction of the bony roof of the sphenoid sinus, was operated on because a malignant tumor was suspected. A destruction of the bony walls of the sphenoid sinus was found. The histological examination of the "glue"-like "tumorous" material revealed an aspergillosis. The patient developed an aspesrgillus meningitis postoperatively. Intrathecally administered Amphotericin B led to an improvement of the meningitis, but caused a fatal renal failure. A review of the literature showed that only 7 cases of aspergillosis of the sphenoid sinus have been reported, 3 of which presented with a tumor-like destruction of the sinus. An aspergilloma of the sphenoid sinus is therefore a rare but important differential diagnosis in patients with a suspected malignancy of the infrasellar region.
 ...
PMID:[Aspergilloma of the sphenoid sinus with aspergillus meningitis (author's transl)]. 709 92

A case of aspergillotic meningoencephalitis associated with trigeminal neuralgia was reported. The patient, a 41-year-old female, was admitted to our hospital on Nov. 20, 1977 with the chief complaint of right trigeminal neuralgia. On admission right facial paresthesia and right abducens palsy were found. The skull x-ray and tomogram showed enlargement of the right superior orbital fissure. Ct scan revealed an irregular high density around the right superior orbital fissure. The examination of spinal fluid showed 75 mg/dl protein, 72 mg/dl sugar and 11 cells. A biopsy of the mass and trigeminal rhizotomy were performed on Dec. 21, 1977. Microscopically, the specimen was composed of nonspecific granulomatous inflammatory tissue. Thereafter, loss of visual acuity, total ophthalmoplegia and facial paresis gradually appeared on the right side with high fever elevation. Immunologically, peripheral blood lymphocytes responded normally to PHA and PWM, but numbers of lymphocytes showed a tendancy of decrease with deterioration. On the other hand, serum IgG and IgM levels were rather increased. CT scan showed that an irregular high density mass extended to the right orbital apex and the pterygoid fossa. Spinal fluid revealed 260 mmH2O pressure with 76 mg/dl protein, 55 mg/dl sugar and 293 cells, but no organisms were demonstrated. Four months after the operation, swelling of the right subtemporal region became remarkable, in which region a puncture revealed much pus retention, and Aspergillus fumigatus was cultured from the aspirated pus. The patient became comatose and died on May 20, 1978. Autopsy showed thick, yellowish green pseudomembranes covering from the right temporal tip to the basal cistern. The both of cerebral hemispheres were swollen and revealed multiple small softenings all over the brain. Small hemorrhage occupying the right temporal subcortex and microabscess located in the left thalamus were also seen. Microscopical examination disclosed that the pseudomembrane was composed of the necrotizing suppurative inflammation with branched septate hypha of Aspergillus. There have been a few reports of aspergillotic meningoencephalitis associated with trigeminal neuralgia and enlargement of the superior orbital fissure like this case. Some discussion was made on the importance for the diagnosis of aspergillosis to perform fungal culture and histological examination of materials obtained from the inflammatory site, and immunological data of this case was also presented.
 ...
PMID:[A case of aspergillotic meningoencephalitis associated with trigeminal neuralgia]. 713 7

Two cases of non-invasive aspergillosis of the nose and paranasal sinuses are described. The first presented with left proptosis and ophthalmoplegia. Imaging and histology showed a maxillary sinus aspergilloma. The second case presented as a compressive optic neuropathy and histology showed allergic aspergillus sinusitis. The pathological distinction between invasive and non-invasive forms of aspergillus sinusitis is important as in invasive aspergillosis surgical treatment is most effectively combined with systemic antifungal treatment, whereas in aspergilloma of the paranasal sinuses surgical drainage of the sinuses alone is usually sufficient, and in allergic aspergillus sinusitis surgery is best combined with systemic or topical steroids. The distinction between invasive and non-invasive forms is particularly important as both may present with cranial neuropathies.
 ...
PMID:Neuro-ophthalmological presentation of non-invasive Aspergillus sinus disease in the non-immunocompromised host. 812 16

Rhino-cerebral fungal infections are rare and difficult disorders to cure. We report the case of a woman presenting a left trigeminal neuralgia complicated by ophthalmoplegia and blindness. MRI demonstrated a lesion of the left orbital apex with extension into the cavernous sinus. Fungal infiltration (aspergillosis or mucormycosis), was seen on biopsy. High-dose liposomal Amphotericin B (5mg/kg/day) for six weeks was unsuccessful. Adjunctant hyperbaric oxygen therapy led to clinical and radiological improvement. Hyperbaric oxygen therapy is discussed in the medical management of rhino-cerebral yeast abscesses.
 ...
PMID:[Rhino-cerebral fungal infection successfully treated with supplementary hyperbaric oxygen therapy]. 1497 21

Fulminant-invasive sinus aspergillosis affects immunocompromised patients and is usually lethal because of intracranial complications. Chronic-invasive and non-invasive types occur in non-immunocompromised patients. In these cases, intracranial extension is possible and life-threatening. The effective management of sinus aspergillosis requires early diagnosis by CT and histological classification, surgery, and if necessary, chemotherapy or steroids in case of allergy. Here we report a successfully treated case in a 29-year-old non-immunocompromised patient with chronic-invasive sinus aspergillosis. He presented a recurrent sphenoid sinus aspergillosis with destruction of the clivus and ophthalmoplegia. Diagnostic and therapeutic procedures are described.
 ...
PMID:[Course and therapy of an invasive aspergilloma of the skull base in a non-immunocompromised patient]. 1530 53

Painful ophthalmoplegia is caused by the lesions of orbital apex and anterior cavernous sinus. Cavernous sinus syndrome can be produced by intracranial invasive aspergillosis. A case of painful ophthalmoplegia due to invasive aspergillosis caused by Aspergillus niger in a diabetic patient is presented.
 ...
PMID:Invasive aspergillosis producing painful ophthalmoplegia. 1645 37

We report the case of a 58-year-old woman in whom relapsing painful ophthalmoplegia related to a mycetoma of the sphenoid sinus gave origin to meningitis with markedly depressed glucose levels in the cerebrospinal fluid. Surgical exeresis of the mycetoma allowed aetiological diagnosis (aspergillosis) and--together with antimycotic therapy--led to durable clinical response.
 ...
PMID:Meningitis following relapsing painful ophthalmoplegia in aspergillus sphenoidal sinusitis: a case report. 1699 35


1 2 Next >>