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)

A 57-year-old housewife, with controlled hypertension, presented with acute right proptosis and visual loss with external ophthalmoplegia due to spontaneous orbital haemorrhage. Vision and ocular motility were returned to normal by the rapid surgical evacuation of the blood. Acute orbital haemorrhage is an ocular emergency requiring urgent treatment to prevent the usual previously reported outcome of permanent visual loss.
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PMID:Spontaneous orbital haemorrhage. 649 39

The Tolosa-Hunt syndrome is characterized by recurrent unilateral painful ophthalmoplegia which responds to systemic steroid therapy dramatically. The etiology appears to be a non-specific inflammation in the cavernous sinus and the superior orbital fissure. Two interesting cases similar to this syndrome are described. One is a 54-year-old man with moderate left exophthalmos who had no complaint of retro-orbital pain. CT scan demonstrated the left orbital tumor, and the orbital decompression surgery was performed. The white-yellowish tumor was found extending the orbit through the superior orbital fissure into the cavernous sinus. Histological examination revealed non-specific inflammatory granuloma. Despite the unusual clinical symptoms, the etiology of this case appeared to be identical with the Tolosa-Hunt syndrome. The other case is a 16-year-old girl who had a 2 years' history of recurrent left retro-orbital pain and the complete IIIrd nerve palsy. CT scan demonstrated a small enhancing lesion in the cavernous sinus. Corticosteroid treatment improved her IIIrd nerve palsy within 2 days, however the CT scan after the treatment revealed no change of the lesion size. Left frontotemporal craniotomy was performed and the whitish tumor in the cavernous sinus was partially removed. Histological examination revealed that the tumor was typical meningioma with whorl-formation. The anatomical structure of the cavernous sinus is so complicated that the diseases arising from this area show quite different appearances. For the differential diagnosis of these lesions, the carotid angiography and the cavernous sinus venography were said to be useful.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[2 cases simulating Tolosa-Hunt syndrome]. 662 87

Meningiomas sometimes invade into the surrounding structures, especially into the sinuses, and show remote extracranial metastasis. Meningiomas of the sphenoid ridge sometimes extend and invade into the cavernous sinus, diaphragma sellae, sphenoid and ethmoid sinuses, orbit and the pterygomaxillary fossa. A case of the tumor of the right sphenoid ridge, which recurred into the orbit and the pterygomaxillary fossa two years after the total removal, was presented. Histological examinations of both the first and second tumor showed meningotheliomatous meningioma. A 61-year-old female was admitted on January 17, 1980 with a complaint of left hemiparesis, memory disturbance, disorientation and incontinentia urinae. Right carotid angiography and CT scan showed a large high density mass in the right middle cranial fossa, which was totally removed. After the operation, the neurological status rapidly improved and she spent an uneventful life until February 1982 when she noticed right exophthalmos, ophthalmoplegia and visual loss. Right CAG and CT scan at the second admission showed a strongly enhanced mass in the right orbit and pterygomaxillary fossa. Severe destruction of the posterolateral wall of the right orbit and the floor of the right middle cranial fossa was also noticed. The tumor was totally removed, using modified Dieffenbach-Weber-Fergusson approach, which is usually used for the carcinoma of the maxillary sinus. By this approach, we could easily reach the pterygomaxillary fossa, that is, the floor of the middle cranial fossa and the posterolateral wall of the orbit. This approach seemed to be very useful for the removal of the tumors of the skull base.
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PMID:[Meningioma of the sphenoid ridge recurring into the pterygomaxillary fossa following craniotomy. A case report and surgical approach]. 663 11

A patient with advanced severe mycosis fungoides presented several unusual features, including prominent lesions of the palate and tongue and an orbital tumor with exophthalmos and ophthalmoplegia. A hitherto undescribed feature was the development of multiple, massive subcutaneous tumors unrelated to the dermis or to lymph nodes, and large tumors in the connective tissues of the buttock, flank, and retroperitoneum. The usual sites of extracutaneous dissemination of mycosis fungoides--lymph nodes, spleen, liver, lungs, and blood--were not demonstrably involved. This may be a new pattern of dissemination for this disease. Of practical importance is the immediate and complete relief of exophthalmos and ophthalmoplegia that was obtained with emergency radiotherapy.
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PMID:Mycosis fungoides: subcutaneous and visceral tumors, orbital involvement, and ophthalmoplegia. 666 1

The ophthalmological changes in two patients with Erdheim-Chester disease are described. These consist of exophthalmos, ophthalmoplegia, xanthelasma, optic disc swelling, blindness due to optic atrophy, retinal striae, and bilateral enhancing orbital masses on CT scan. The clinical and histopathologic findings of Erdheim-Chester disease are reviewed and the manifestations in two patients with orbital change are presented. This is believed to be the first report describing the ophthalmological manifestations of Erdheim-Chester disease. Our observations support the view that Erdheim-Chester disease is unrelated to the histiocytosis X group.
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PMID:Orbital manifestations of Erdheim-Chester disease. 667 81

Twenty patients with moderately severe ophthalmopathy due to Graves' disease or ophthalmic Graves' disease were treated by supervoltage orbital radiotherapy generated by a linear accelerator. Seven patients (35%) showed some response within 3 weeks of the treatment, four patients (20%) improved minimally while nine patients (45%) were unchanged. Improvement was noted mainly in soft tissue changes while proptosis decreased in only four patients. With one exception, ophthalmoplegia did not improve after the radiotherapy. The benefit obtained with the treatment was not impressive.
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PMID:An evaluation of supervoltage orbital irradiation for Graves' ophthalmopathy. 678 79

Although thyrotoxicosis and orbital complications of acute ethmoid or frontal sinusitis are among the most common causes of unilateral exophthalmos, inflammatory pseudotumor is frequently accompanied by progressive acute unilateral proptosis. Because the associated chemosis, scleral erythema, and ophthalmoplegia constitute a spectrum of clinical findings present in numerous inflammatory orbital disorders and systemic diseases, the diagnosis of inflammatory pseudotumor is one of exclusion, often requiring orbital biopsy. Four patients without evidence of sinusitis, endocrinopathy, collagen vascular disease, or Wegener's granulomatosis are described. The diagnosis of orbital pseudotumor was disclosed by computed axial tomography, thus avoiding orbitotomy. The finding of scleral and choroidal thickening with enhancement following intravenous contrast injection represents a select group of patients with orbital pseudotumor and differentiates them from patients with endocrine exophthalmopathy or neoplasms. This noninvasive technique is extremely valuable because early diagnosis is critical for successful treatment. All four patients responded dramatically to high-dose corticosteroid therapy. In the absence of significant clinical response, however, Wegener's granulomatosis, lymphoma, and rhabdomyosarcoma, especially in younger patients, must be carefully excluded. Orbital exploration or decompression or both are used when proptosis, headache, or orbital pain does not resolve promptly, visual acuity deteriorates, or the diagnosis remains unknown.
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PMID:Computerized axial tomography in inflammatory pseudotumor of the orbit. 682 19

Malignant exophthalmos or the ophthalmic component of Graves' disease is a functionally impairing and cosmetically deforming disorder of orbital tissue, separate from the sympathetic effects of thyrotoxicosis. The deposition of immune complexes of thyroglobulin and its antibodies within orbital muscles results in progressive exophthalmos, ophthalmoplegia, chemosis, and lid fullness. Increasing intraorbital edema and optic nerve tension may produce irreversible retinal ischemia. If unresponsive to medical treatment, patients exhibiting increasing loss of visual acuity are therefore candidates for emergency surgery. Early attempts at surgical correction of the mechanical aspect of Graves' ophthalmopathy were unsuccessful. The current technique of transantral orbital decompression, when done before extreme advancement of the ocular disease, is successful and meets the following objectives: It restores visual loss and prevents further deterioration of visual acuity, protects the cornea, restores extraocular muscle movements, decreases intraorbital pressure, produces a satisfactory cosmetic result, and avoids serious complications. Patients with persistent extraocular muscle imbalance or lid lag may ultimately require oculoplastic surgery.
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PMID:Ophthalmic surgery in malignant exophthalmos. 689 48

A 58-year-old woman had the sudden onset of unilateral painful proptosis, ophthalmoplegia, vomiting, and loss of vision. Computed axial tomography showed a mass that was greatly attenuated in the orbit. The initial reading of the internal carotid angiogram was normal, but a subtraction study showed a hypervascular lesion within the orbit with features indicating a hemangioma. Orbital decompression failed to restore the vision as intraorbital hemorrhage had irreparably damaged the optic nerve.
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PMID:Orbital hemorrhage with loss of vision. 698 56

The terms periorbital (preseptal) and orbital cellulitis are often used interchangeably, obscuring important differences in their pathogenesis, bacterial etiology, clinical presentation and appropriate therapy. A review of 56 cases of periorbital cellulitis indicated that the patients could be divided into three groups: Group 1, cases secondary to paranasal sinusitis, more correctly termed inflammatory edema because the periorbital swelling is due to venous obstruction (a specific bacterial etiology is rarely documented in these patients because aspiration and culture of the sinuses are usually not performed and the infection is not associated with bacterial invasion of either the soft tissue or the blood stream); Group 2, cases associated with disruption of local skin integrity which are usually due to Staphylococcus aureus or Group A streptococci; and Group 3, cases associated with bacteremia usually occurring in infants and young children without other apparent foci of infection and caused by Haemophilus influenzae type b or Streptococcus pneumoniae. Actual infection of the orbital contents (orbital cellulitis or abscess), marked by proptosis and ophthalmoplegia, is rare and is due either to advanced purulent sinusitis or to penetrating orbital trauma.
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PMID:Periorbital cellulitis and paranasal sinusitis: a reappraisal. 717 9


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