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Query: UMLS:C0029089 (ophthalmoplegia)
 3,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The ability of cutaneous squamous cell carcinoma of the face to cause ophthalmoplegia or central nervous system dysfunction via perineural spread is not well recognized. Five patients presenting to a general neurology unit are described in whom partial or complete ophthalmoplegia developed following fifth and seventh cranial nerve involvement by cutaneous squamous cell carcinoma. Two patients subsequently developed a contralateral hemiparesis; and one, multiple cranial nerve palsies as the tumor spread centrally. Normal radiologic findings or complete healing of the primary skin lesion caused delay in the diagnosis in three of the patients. When ophthalmoplegia or central nervous system dysfunction develops as a consequence of perineural spread of cutaneous facial cancer, management is palliative.
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PMID:Perineural spread of cutaneous head and neck cancer. Its orbital and central neurologic complications. 229 96

Ophthalmoplegia and blindness caused by squamous cell carcinoma were reported in a cat. Unilateral functional deficits of cranial nerves II, III, IV, and VI and of the sympathetic nerve supply caused blindness, complete ophthalmoplegia, and Horner syndrome. Radiography and computed tomography revealed a proliferating bony lesion associated with the right tympanic bulla, right temporal bone, right side of the mandible, and left frontal bone. A focal area of bony destruction involved the right sphenoid bone. The cat was euthanatized and necropsied. Squamous cell carcinoma was identified invading the bones and rostral part of the right side of the skull. The tumor had extended through the sphenoid bones into the region of the cavernous sinus and had surrounded the cranial nerves passing through this region. It also had invested connective tissue surrounding the optic nerves and had invaded the right globe through the lamina cribrosa. This represents an unusual distribution for ocular cranial squamous cell carcinoma in a cat.
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PMID:Squamous cell carcinoma causing blindness and ophthalmoplegia in a cat. 279 81

A 70-year-old man who had squamous cell carcinoma of the lip later presented with right mental neuropathy, ipsilateral progressive involvement of all three divisions of the 5th, the 7th and 8th cranial nerves, and complete ophthalmoplegia. Biopsy proven metastasis to the mandible was demonstrated. Although repeated studies of CT scan of the head and cerebral angiography were negative, CSF examination revealed positive cytology, elevated protein and low sugar content. Although vascular dissemination from the primary lip lesion to the mandible and brain stem cannot be ruled out, extension through perineurial space via the 5th cranial nerve have been speculated. This case demonstrates two unusual features of squamous cell carcinoma of the lip, namely metastasis to the mandible and meningeal spread with multiple cranial neuropathies.
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PMID:Unusual manifestations of multiple cranial nerve palsies and mandibular metastasis in a patient with squamous cell carcinoma of the lip. 669 17

A 62-year-old man presented with progressive diplopia, left ptosis, proptosis, complete ophthalmoplegia, facial numbness, and headache of 2 1/2 months' duration. The symptoms started 1 month after surgical resection of a squamous cell carcinoma in the left side of the forehead. Imaging studies helped localize the lesion, correlating with clinical features. The differential diagnosis is discussed. The final diagnosis was confirmed by autopsy.
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PMID:Ophthalmoplegia and facial numbness following treated squamous carcinoma of the forehead. 771 37

Direct surgery to cavernous sinus (CS) lesions has become one of the optimal treatments based on advancement in microsurgical anatomy and imaging modality, and the progress of microsurgical techniques. We have removed the CS or Meckel's cave tumors extradurally when they do not extend intradurally, using modified Al-Mefty's cranio-orbital zygomatic craniotomy. Three CS tumors; trigeminal neurofibroma, squamous cell carcinoma and chondrosarcoma, and a Meckel's cave meningioma were reported. Total removal was achieved in all but one (case 4). Postoperative complications were permanent ophthalmoplegia in one, transient ophthalmoplegia in one, subcutaneous CSF accumulation in two and trigeminal dysfunction in one. The extradural approach can be the first choice of methods for total removal of tumors when they are confined to the CS or Meckel's cave.
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PMID:[Cranio-orbital zygomatic extradural approach for cavernous sinus or Meckel's cave tumors]. 867

The paper aims to present the case of a progressive and unilateral cranial polyneuropathy due to perineural spread of cutaneous squamous cell carcinoma. This is a case of a 73 year old man with a history of squamous cell carcinoma in the right temporal region that was removed in 1992. In May 2000 he first presented pain and numbness in the distribution of the first branch of right trigeminal nerve and weakness of the ipsilateral frontal muscle. Later on he presented right ophthalmoplegia, and damage of lower cranial nerves, leading to dysphagia and respiratory distress. He was admitted in March 2001 for a gastrostomy for feeding, when ataxia and recurrence of the right temporal lesion ensued. After three examinations with MRI, the fourth study showed meningeal carcinomatous and a metastatic lesion in the brainstem. Histopathologic examination demonstrated dermal and perineural invasion by squamous cell carcinoma. The necropsy also showed meningeal, perineural and endoneural infiltration of atypical epidermal cells and a pons mass composed of the same cells. We conclude that the perineural spread of the cutaneous carcinoma is an exceptional cause of cranial neuropathy, however it must be ruled out in patients with progressive and unilateral cranial neuropathy. In these cases, when no radiological abnormalities are noted, a biopsy may be performed on the peripheral branches of the cranial nerve to confirm the diagnosis.
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PMID:[Progressive cranial neuropathy due to perineural spread of a facial squamous cell carcinoma]. 1261 Jul 61

A 55-years-old man with a history of alcoholism, hypertension and obesity was diagnosed of epidermoid carcinoma of the middle third portion of the esophagus. He was treated with two cycles of cytostatics with cisplatin and 5-fluorouracil. Due to his poor general health an inability to swallow solids and liquids, he received parenteral nutrition for 20 days using a commercial formula lacking in vitamins and minerals. During distal esophagectomy we observed a tendency to hypotension and severe metabolic acidosis that was unexplained by the hemodynamic profile and that persisted throughout the first 24 hours after surgery. Once these complications were corrected, he was weaned from mechanical ventilation and the following neurological signs were observed: temporal and spacial disorientation, aphasia, ophthalmoplegia with divergent strabismus and later conduction aphasia, amnesia and confabulation. Circulation was hyperdynamic, requiring inotropics and vasoconstrictors. Korsakoff syndrome secondary to Wernicke's encephalopathy was diagnosed, and the response to thiamine treatment was favorable. Beriberi can be found in hospitalized patients and the anesthesiologist may be involved in their perioperative care. Symptoms resolve easily with vitamin B1 treatment, which is ideally provided along with other hydrosoluble vitamins. Treatment should be prompt because delay leads to greater morbiomortality.
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PMID:[Beriberi after esophagectomy]. 1267 75

A 64-year-old female presented with rapid onset of left ophthalmoplegia and truncal ataxia, after experiencing diplopia due to left abducens nerve palsy for a year. She had undergone surgery twice for left trigeminal neuralgia caused by a large intracranial epidermoid cyst at the age of 48 and 52 years. The intracranial epidermoid cyst grew and became predominantly enhanced by contrast medium on computed tomography (CT) and T(1)-weighted magnetic resonance (MR) imaging, which had not been observed earlier. The tumor was partially removed and the histological diagnosis was squamous cell carcinoma (SCC). Radiation therapy was administered, but she presented with paraplegia of the bilateral lower extremities and anesthesia due to spinal multiple metastases of SCC one year later. Radiation therapy was administered for the spinal lesions, but she died of multiple metastases to the cerebellum and medulla oblongata with hydrocephalus 2 years after the third surgery. Transformation of intracranial epidermoid cysts to SCC appears as predominant enhancement on CT or T(1)-weighted MR imaging with rapid deterioration of neurological features. All reported cases of malignant transformation of intracranial epithelial cysts to SCC with leptomeningeal carcinomatosis have occurred in intracranial epidermoid cysts.
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PMID:Malignant transformation of an intracranial large epidermoid cyst with leptomeningeal carcinomatosis: case report. 2044 35

A 43-year-old woman (Case 1), 63-year-old man (Case 2), and a 67-year-old man (Case 3) presented with diplopia (Cases 1, 2, and 3) and upper-eyelid ptosis (Cases 1 and 3). The cases had preceding cranial nerve V1 disturbances ranging from 3 months to 8 years. Each demonstrated complete internal ophthalmoplegia and external ophthalmoplegia. No case had a cutaneous squamous cell carcinoma (SCC) on presentation or by history. Imaging revealed isolated orbital apex masses. Tumor biopsies revealed SCCs of various differentiations. Systemic workup revealed no extraorbital malignancy. All received radiation therapy, and 2 patients underwent adjuvant chemotherapy. One patient is alive since diagnosis (49 months). In Case 2, SCC developed in the contralateral orbit, and the patient died 19 months after diagnosis; and Case 3 died 12 months after diagnosis. These isolated cases of orbital SCC may have arisen from orbital choristomatous squamous epithelium, may represent de novo or metastatic tumors, or may be manifestations of occult perineural spread.
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PMID:Isolated squamous cell carcinoma of the orbital apex. 2520 79

The swollen red eyelid is a common presentation in primary care. An understanding of the anatomy of the orbital region can guide care. Factors that guide diagnosis and urgency of care include acute vs. subacute onset of symptoms, presence or absence of pain, identifiable mass within the eyelid vs. diffuse lid swelling, and identification of vision change or ophthalmoplegia. Superficial skin processes presenting with swollen red eyelid include vesicles of herpes zoster ophthalmicus; erythematous irritation of contact dermatitis; raised, dry plaques of atopic dermatitis; and skin changes of malignancies, such as basal or squamous cell carcinoma. A well-defined mass at the lid margin is often a hordeolum or stye. A mass within the midportion of the lid is commonly a chalazion. Preseptal and orbital cellulitis are important to identify, treat, and differentiate from each other. Orbital cellulitis is more often marked by changes in ability of extraocular movements and vision as opposed to preseptal cellulitis where these characteristics are classically normal. Less commonly, autoimmune processes of the orbit or ocular tumors with mass effect can create an initial impression of a swollen eyelid.
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PMID:Differential Diagnosis of the Swollen Red Eyelid. 2617 69


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