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

Two patients with left painful ophthalmoplegia, caused by infiltrating lesion in left superior orbital fissure and/or cavernous sinus, subsequently developed left cerebral infarction associated with occlusion of the proximal portion of left internal carotid artery demonstrated by CT and angiogram. It thus is worthy to remind that painful ophthalmoplegia may have the possibility of resulting in cerebral infarction associated with carotid occlusion.
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PMID:Internal carotid artery occlusion in painful ophthalmoplegia. 166 89

The neurologic evaluation of an individual cardiac transplant recipient often does not lead to a succinct bedside diagnosis. There are few consistent clinical observations. The onset of seizures in the early postoperative period is associated with embolic cerebral infarction. Seizures occur most commonly, however, as a neurotoxic manifestation of cyclosporine. The onset of an acute delirium or psychosis in the first week after cardiac transplantation usually has multiple causative factors and is reversible. A postoperative brachial plexopathy or mononeuropathy can be identified with a neurologic examination, confirmed by appropriate electrophysiologic testing and is usually reversible. The onset of periorbital inflammation, ophthalmoplegia, and nasal turbinate or sinus invasion and necrosis is consistent with phycomycosis. Most patients, however, present with nonspecific findings of impaired mentation with or without focal neurologic signs. These patients require a fairly systematic search for potentially treatable neurologic complications (see Table 3). In a medically stable patient an aggressive diagnostic approach, at times including stereotaxic brain aspirate or biopsy, is indicated. In the severely ill patient with multiple organ failure, empirical therapy for the most probable treatable disorder is justified.
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PMID:Neurologic complications of cardiac transplantation. 304 45

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.
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PMID:Sino-orbital aspergillosis associated with total ophthalmoplegia. 396 52

Two cases of rhinocerebral mucormycosis in elderly, non-ketotic diabetics who were initially diagnosed and treated for bacterial periorbital cellulitis are reported. Both presented with a short history of periorbital pain and swelling followed rapidly by complete ophthalmoplegia and blindness. By the time of correct diagnosis, both cases were advanced with lower cranial nerve involvement, CT evidence of ophthalmic artery and cavernous sinus thrombosis and, in one, internal carotid artery invasion (demonstrated on MR angiography) with resultant cerebral infarction. One patient was treated with intravenous amphotericin B but died within a few days. The second patient had aggressive surgical resection and survived with significant residual morbidity. These cases illustrate that mucormycosis should be excluded in any diabetic patient presenting with orbital cellulitis, especially when there is early visual loss. Early aggressive treatment with surgery and antifungal agents is often successful whereas the outcome is almost universally fatal when the diagnosis is delayed.
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PMID:Rhinocerebral mucormycosis presenting as periorbital cellulitis with blindness: report of 2 cases. 758 67

A 50-year-old woman with antiphospholipid antibody syndrome (APAS) awoke in a morning to notice dizziness, so she came to our hospital. Several hours later she developed left oculomotor paralysis. Further two hours later she developed right oculomotor paralysis and could not stand. Brain MRI showed high signal intensity lesion of paramedian thalamic and midbrain on the T2-weighted image. Cerebral angiography did not reveal any occlusion. Transesophageal echocardiography disclosed mitral valvular vegetation. We thought this valvular abnormality was non-bacterial thrombotic vegetation associated with APAS and this suggests that cerebral infarction was due to emboli from this vegetation.
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PMID:[Brain infarct due to non-bacterial thrombotic valvular vegetation associated with primary antiphospholipid antibodies--a case report]. 1020 77

A 29-year-old man presented with lethargy, headache, high fever, and visual disturbance. Neurological examination showed mydriatic pupil, ptosis, diminished light reflex, and ophthalmoplegia on the left. Magnetic resonance (MR) imaging showed the typical findings of pituitary apoplexy, and cerebral angiography disclosed mild narrowing of the A1 segment of the left anterior cerebral artery (ACA). Transsphenoidal tumor resection was performed. Transient severe right hemiparesis occurred directly after the operation. Computed tomography demonstrated cerebral infarction in the territory of the left Heubner's and medial lenticulostriate arteries. Pituitary apoplexy followed by cerebral infarction is very rare. Vasospasm of the perforating arteries of the ACA probably caused the cerebral infarction. Subarachnoid blood or vasoactive agents released from the tumor were the most likely cause of the vasospasm. MR imaging findings of contrast enhancement around the vessels may indicate reactive processes around the vessels.
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PMID:Cerebral infarction following pituitary apoplexy--case report. 1560 Feb 83

Internuclear ophthalmoplegia (INO) is a distinctive ocular motor disorder resulting from dysfunction of the medial longitudinal fasciculus, which lies in the pontine tegmentum. We retrospectively analyzed clinical and magnetic resonance imaging (MRI) findings for four consecutive patients with internuclear ophthalmoplegia who were treated in our hospital. The causes of the disease were cerebral infarction in three cases and multiple sclerosis in one case. Vertigo and facial nerve palsy were associated in three cases and one case, respectively. MRI studies visualized an ischemic lesion in the responsible portion of the brainstem in one patient but failed to reveal responsible lesions in the other three patients. All the patients completely recovered in 1 to 22 days, with an average recovery period of 9.3 days. The etiology, diagnosis and management of INO were bibliographically reviewed.
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PMID:[Clinical and MRI findings of patients with internuclear ophthalmoplegia]. 1652 16

We reported a case of cavernous sinus aspergillosis. A 62-year-old man complained of trigeminal neuralgia in the right V1 region. Neurological examination on admission showed ptosis, loss of light reflex and ophthalmoplegia externa in the right side. MRI enhanced with gadolinium demonstrated sphenoid sinusitis and mass lesion in the right cavernous sinus. MRA revealed right internal carotid artery occlusion. An open biopsy using the extradural temporopolar approach was performed. Pus discharge was observed from the cavernous sinus and histological examination showed hypha of Aspergillus. With early voriconazole treatment, the patient had improvement in headache, ptosis and ophthalmoplegia externa. Cavernous sinus aspergillosis is often found after sphenoiditis. It results in invasion to an internal carotid artery and worsens the patient's prognosis by cerebral infarction, so early diagnosis and treatment are important. We should consider aspergillosis as one of the differential diagnoses of a mass in the cavernous sinus. The epidural approach to this lesion was available to obviate aspergillus dissemination into the medullary cavity.
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PMID:[A case of cavernous sinus aspergillosis]. 2409 62

Ehlers-Danlos syndrome (EDS) is a rare inherited connective disease. Among several subgroups, type IV EDS is frequently associated with spontaneous catastrophic bleeding from a vascular fragility. We report on a case of carotid-cavernous fistula (CCF) in a patient with type IV EDS. A 46-year-old female presented with an ophthalmoplegia and chemosis in the right eye. Subsequently, seizure and cerebral infarction with micro-bleeds occurred. CCF was completely occluded with transvenous coil embolization without complications. Thereafter, the patient was completely recovered. Transvenous coil embolization can be a good treatment of choice for spontaneous CCF with type IV EDS. However, every caution should be kept during invasive procedure.
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PMID:Spontaneous Carotid-Cavernous Fistula in the Type IV Ehlers-Danlos Syndrome. 2465 3

We report 2 cases of central retinal artery occlusion with concomitant ipsilateral cerebral infarction after cosmetic facial injections and a literature review. The 2 patients were two healthy women, in which cosmetic facial injections with autologous fat and filler were performed, respectively. The patients had no light perception at the final visit and their conditions led to memory retrieval disturbance in case 1 and right arm weakness, dysarthria, facial palsy, and ophthalmoplegia in case 2. Neuroimaging showed multifocal small infarctions in the ipsilateral frontal lobe with occlusion of the ophthalmic artery in case 1 and multiple infarctions in the ipsilateral anterior and middle cerebral artery territories with subsequent hemorrhagic transformation in case 2. Poor visual prognosis and neurological complications can occur in healthy adults undergoing cosmetic facial injection, and all patients should be informed of this risk before the procedure.
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PMID:Central retinal artery occlusion with concomitant ipsilateral cerebral infarction after cosmetic facial injections. 2520 14


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