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)

Three cases of histologically verified neurinomas of the oculomotor nerve are reported. The preoperative diagnosis in all three cases was not made; on the contrary all cases were diagnosed as sphenoid ridge meningiomas. The oculomotor neurinoma manifests itself in the beginning with a discrete progressive palsy of the oculomotor nerve leading in later stages to complete ophthalmoplegia. Proceeding the oculomotor nerve paresis or going parallel to it is a functional loss of the homolateral optic nerve sometimes progressing to amaurosis. Unilateral exophthalmos as well as frontal or orbital neuralgic pain with or without sensory disorders in the area of trigeminus-I are characteristic for the clinical picture in later stages, all symptoms characteristic for the syndrome of the apex orbitae, resp. the superior orbital fissure, resp. the anterior cavernous sinus. The differential diagnosis has to consider above all the sphenoid ridge meningioma, the trigeminal neurinoma and the numerous tumors within the cavernous sinus (aneurysmas, meningiomas, chondromas, metastases of carcinomas, pituitary adenomas etc.) or the middle cranial fossa. Plain X-ray, carotid angiogram and computer tomogram are essential diagnostic means for localization and extension of the tumor but not for histological diagnosis. Oculomotor neurinomas are very seldom. The three observed cases did not have any relation to a possible generalized neurofibromatosis.
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PMID:[Neurinoma of the oculomotor nerve (author's transl)]. 65 Dec 44

Two hundred and twenty-seven cases of carcinoma metastatic to the eye and orbit have been reviewed previously. The orbit alone was involved in 28 cases: theses lesions constitute the basis of this clinicopathologic study. The most common signs and symptoms produced by orbital metastasis included exophthalmos (75%1, pain (29%), decreased vision (29%), periorbital swelling (25%), a visible mass (21%), ophthalmoplegia, and diplopia (18%). The ophthalmologists' preoperative (or premortem) clinical diagnoses were: orbital mass, 36%; metastatic carcinoma, 29%; leukemia, 7%; melanosarcoma, 4%; mixed tumor of lacrimal gland, 4%; and meningioma, 4%. The sites of the primary tumors in the 28 patients with orbital metastasis were as follows: breast, eight; lung, four; genitourinary tract, four; pancreas, one; and ileum, one. In 10 patients the site of the primary carcinoma was not determined. In 17 of the 28 patients, symptoms of orbital metastasis preceded detection of a primary tumor elsewhere in the body. In 10 of the remaining 11 patients, detection of the primary tumor had preceded the onset of orbital symptoms. In one patient, symptoms of the primary tumor and of orbital metastasis appeared at about the same time. The median survival of patients with carcinoma metastatic to the orbit was 15.6 months from the time of orbital surgery. This was much better than the median survival of the 227 patients in the overall study (7.4 months) and far better than the median survival of the patients with metastasis to the anterior segment of the eye (only 5.4 months).
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PMID:Carcinoma metastatic to the eye and orbit III. A clinicopathologic study of 28 cases metastatic to the orbit. 95 71

The Tolosa-Hunt syndrome consists of painful ophthalmoplegia caused by cavernous sinus inflammation, which is responsive to steroid therapy. The MR features of 11 patients with the clinical diagnosis of Tolosa-Hunt syndrome were studied. Two patients had normal MR studies of the orbit and cavernous sinuses. In nine patients, abnormal signal and/or mass lesions were seen in the cavernous sinuses; in eight cases, the abnormality was hypointense relative to fat and isointense with muscle on short TR/TE images and isointense with fat on long TR/TE scans. Extension into the orbital apex was seen in eight cases. In six of nine cases the affected cavernous sinus was enlarged; in five of nine it had a convex outer margin. One patient had a thrombosed cavernous sinus and superior ophthalmic vein in addition to a cavernous sinus soft-tissue mass. The signal intensity of Tolosa-Hunt syndrome in this limited series was similar to that of orbital pseudotumor and is confined to a limited differential diagnosis, which includes meningioma, lymphoma, and sarcoidosis.
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PMID:MR imaging of Tolosa-Hunt syndrome. 210 3

The eradication of basicranial meningiomas by traditional surgical techniques is often hindered by neoplastic entanglement with critical neurovascular structures. Apparent, complete tumor resection is frequently followed by extensive, yet clinically silent, recurrent disease with local infiltration of bone, cranial nerves, and brain. Fifty-five cases of sphenoid wing or parasellar meningioma were analyzed to identify clinical manifestations suggestive of early tumor recurrence. Regrowth patterns were then defined according to preoperative radiographic and intraoperative surgical findings. Medial tumor regrowth, involving the cavernous sinus, caused neurapraxia of cranial nerves III, IV, or VI, with associated diplopia or ophthalmoplegia. Inferior (caudal) regrowth of disease involved the infratemporal fossa, pterygomaxillary space, or paranasal sinuses by bony erosion of the middle cranial fossa floor or through natural anatomic foramina and fissures. Such inferior extension was manifested clinically by facial hypesthesia, trismus, and referred otalgia caused by trigeminal nerve involvement and by autophony or serous otitis media related to eustachian tube obstruction. Posterior tumor regrowth occurred along the petrous bone and horizontal carotid canal, resulting in internal auditory meatus erosion and cerebellopontine angle extension with associated tinnitus, hearing loss, unsteadiness, and occasional facial twitching. While the clinical and radiographic evaluations of any patient with a suspected recurrent basicranial meningioma are critical in planning the method and magnitude of reoperation, an understanding of potential recurrence patterns can be used in devising more extensive, combined approaches that may allow complete tumor extirpation at the initial surgical intervention.
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PMID:Meningiomas of the lateral skull base: neurotologic manifestations and patterns of recurrence. 212 32

The Tolosa-Hunt syndrome consists of painful ophthalmoplegia caused by cavernous sinus inflammation, which is responsive to steroid therapy. The MR features of 11 patients with the clinical diagnosis of Tolosa-Hunt syndrome were studied. Two patients had normal MR studies of the orbit and cavernous sinuses. In nine patients, abnormal signal and/or mass lesions were seen in the cavernous sinuses; in eight cases, the abnormality was hypointense relative to fat and isointense with muscle on short TR/TE images and isointense with fat on long TR/TE scans. Extension into the orbital apex was seen in eight cases. In six of nine cases the affected cavernous sinus was enlarged; in five of nine it had a convex outer margin. One patient had a thrombosed cavernous sinus and superior ophthalmic vein in addition to a cavernous sinus soft-tissue mass. The signal intensity of Tolosa-Hunt syndrome in this limited series was similar to that of orbital pseudotumor and is confined to a limited differential diagnosis, which includes meningioma, lymphoma, and sarcoidosis.
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PMID:MR imaging of Tolosa-Hunt syndrome. 251 79

A medical history of a 46-year-old male is reported. At 23 years of age, he started having diffuse pain in the left side of his head for up to 30 min once or twice a month. At 28, the pain changed into left-sided cluster headache-like attacks with 2-3 h duration and with ipsilateral conjunctival injection, lacrimation, and rhinnorhea, but with short-lasting free intervals of about two to three weeks. At 36, the pattern of the attacks corresponded to chronic migrainous neuralgia. At 40, the symptoms changed to painful ophthalmoplegia-picture. A left-sided parasellar meningioma was then diagnosed. Removal of the tumor caused complete amelioration. The case history is suggested to support the hypothesis that the cavernous sinus region is involved in cluster headache.
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PMID:A case of parasellar meningioma mimicking cluster headache. 261 84

A 46-year-old woman with right sphenoidal ridge meningioma (alar type), which recurred in the orbit and the pterygomaxillary fossa three years after total removal, is presented. Histologically the first examination showed transitional type meningioma. She noticed right exophthalmos, ophthalmoplegia, visual disturbance and swelling of the right side of the face three years later. Microscopically, the tumor showed malignant meningioma. Electron microscopic examination of the specimen disclosed the nucleoli lying on the nuclear membrane, interdigitation with desmosomes, polymorphous mitochondria, free ribosomes, glycogen granules and an enlarged Golgi apparatus. In conclusion, this patient had a transitional type of meningioma when it first presented, but developed malignant histological features invasion at extracranial sites three years later.
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PMID:[Extracranial recurrence of sphenoidal ridge meningioma--a case report]. 373 76

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

Resection of an orbital meningioma in a 53-year-old patient caused an occlusion of the central retinal artery and total ophthalmoplegia. Eight weeks postoperatively rapid development of a black disc was observed with migration of pigment into the juxtapapillary retina. One year later the eye was removed during a radical reoperation. Histological and ultrastructural examination showed that the melanosis of the disc and the retina was apparently due to reactive proliferation of the juxtapapillary pigment epithelium which had migrated into the atrophic tissues of the retina and the disc. The histological differentiation from hamartomatous proliferations of the juxtapapillary pigment epithelium is discussed. The proliferated pigment epithelium cells in this patient resemble those described in epiretinal membranes apart from abundant RER and actin filaments. In the absence of mechanical or inflammatory factors it must be assumed that hypoxia was the stimulus responsible for the proliferation. The presence of fenestrated retinal capillaries in the proliferation zone is described and the significance of this finding is discussed.
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PMID:[Acquired black disc and melanotic retina after resection of an orbital meningioma (author's transl)]. 733 49


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