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

Magnetic resonance imaging (MRI) was performed in 20 patients with multiple sclerosis and abnormal electro-oculographic examination. All but 2 patients showed MRI abnormalities in the infratentorial region: hypersignal on T2-weighted sequences and/or images of atrophy. Usually, each patient had multiple abnormalities, which could prevent anatomico-oculographic correlations. With oculomotor disorders of cerebellar origin, correlations between clinical findings and MRI images were satisfactory, but with disorders due to brainstem lesions correlations were not so good, as shown by the results in 9 patients with internuclear ophthalmoplegia.
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PMID:[Contribution of MRI to the topography of oculomotor disorders in multiple sclerosis]. 240 28

Computed tomographic scanning is an excellent modality for evaluation of most orbital and intracranial tumors and strokes. However, MR scanning is definitely superior to CT when evaluating for multiple sclerosis, posterior fossa lesions (evaluation of gaze palsies, internuclear ophthalmoplegia, and downbeat nystagmus), or when assessing an area where sagittal scanning is important (chiasmal lesions). Magnetic resonance has increased specificity when the CT is equivocal. Although MR and CT may be complementary in the information they provide, many clinical studies have shown MR to be superior to CT in evaluating cerebral infarctions, hematomas, the intracanalicular optic nerve, optic chiasm, sella turcica, and the cavernous sinus. Magnetic resonance generally has replaced metrizamide CT cisternography as the procedure of choice for evaluating the suprasellar cistern and posterior fossa. Computed tomography is still preferable for major trauma, especially involving acute fractures and hematomas, although MR is more sensitive to the more subtle intracerebral lesions, such as shear injuries and subdural hematomas, that may provide prognostic information. Computed tomography also is preferred in situations where detecting small amounts of calcification is important for the differential diagnosis. As the development of MR imaging continues with faster scan times, finer spatial resolution, the use of paramagnetic contrast agents, and with increased availability and decreased cost, MR imaging may become preferable to CT as the imaging modality of choice for the CNS and orbit.
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PMID:Neuroimaging in neuro-ophthalmology. 262 24

Internuclear ophthalmoplegia is a gaze disorder characterized by impaired adduction on the side of a lesion involving the medial longitudinal fasciculus with dissociated nystagmus of the abducting eye. Eleven patients with internuclear ophthalmoplegia (nine with clinical multiple sclerosis, two with clinical infarction) underwent MR imaging with spin-echo techniques on a 1.5-T system. Nine patients also had CT. MR showed focal or nodular areas of high signal intensity on T2-weighted images in the region of the medial longitudinal fasciculus in 10 of 11 patients. In one of four patients with internuclear ophthalmoplegia who had MR after intravenous gadolinium-DTPA, an enhancing ring lesion was seen in the region of the medial longitudinal fasciculus on short TR/TE images, indicating active blood-brain-barrier disruption, which correlated with this patient's recent-onset internuclear ophthalmoplegia. CT failed to show the lesions in all nine patients examined. This report demonstrates the superiority of MR in evaluating gaze disorders attributable to brainstem dysfunction, such as internuclear ophthalmoplegia, and correlates MR findings with the relevant neuroanatomy of the medial longitudinal fasciculus.
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PMID:Internuclear ophthalmoplegia: MR-anatomic correlation. 310 83

Otoneurological and ultra low field MRI findings in multiple sclerosis patients: 22 patients suffering from multiple sclerosis (MS) underwent thorough neurological and otological examination, extensive ENG testing and Magnetic Resonance Imaging (MRI) examination of the central nervous system. All patients fulfilled the Schumacher criteria for a diagnosis of definitive MS. 20 of the patients had been included in previous otoneurological studies three to five years ago. The general disability assessed according to Hyllested's scale was: Class 1-7, Class 2-4, Class 3-6, Class 4-3, Class 5-2 patients. Thus 11 patients had none or only slight disability. Nevertheless, all patients showed abnormal findings when classified according to the Kurtzke disability scale, which reflects the involvement of separate neuronal entities. The ENG examination revealed abnormal findings in all patients. The most common abnormalities found were as follows: abnormal pendular test 19, ocular fixation index 18, optokinetic nystagmus 14, saccadic eye movements 14 and spontaneous nystagmus 12. 14 patients had uni- or bilateral abnormally slow adduction movements in the saccadic test consistent with internuclear ophthalmoplegia (INO), which is caused by a lesion of the brain stem. MRI examination of the 21 patients studied revealed abnormal findings consistent with MS in sixteen cases. The lesions were unilateral in 5 and bilateral in 11 patients. The most common location for these abnormal findings consistent with MS plaques were in the white matter around the lateral ventricles. Plaques in the brain stem and/or cerebellum were found in only two cases despite numerous clinical and otoneurological findings that indicated the presence of functional lesions in these areas.
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PMID:Otoneurological and ultra low field MRI findings in multiple sclerosis patients. 320 65

A case is reported of an acute onset of previously undiagnosed multiple sclerosis, revealed by an oculomotor paralysis following spinal anaesthesia performed for minor orthopaedic surgery. The need for a complete preoperative physical examination is underlined by this case, looking for latent neuromuscular disorders before undertaking such techniques, and for a thorough neurological work-up should such a complication arise. The harmlessness of regional anaesthesia in multiple sclerosis patients is controversial; without entering into such a debate, the direct relationship between spinal anaesthesia and acute exacerbation of the disease in our patient seemed more than likely.
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PMID:[Multiple sclerosis disclosed by spinal anesthesia]. 334 16

The case of a 25-year-old female with bilateral internuclear ophthalmoplegia as a presenting feature of systemic lupus erythematosus (SLE) is described. It is important to recognize that bilateral internuclear ophthalmoplegia may be an early manifestation of cerebral involvement in SLE in addition to its occurrence in multiple sclerosis.
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PMID:Bilateral internuclear ophthalmoplegia in systemic lupus erythematosus. 356 Jan 4

An 18-year-old girl developed a reversible locked-in state with bilateral ptosis and almost complete ophthalmoplegia. She later presented with a relapsing and remitting course suggestive of multiple sclerosis. Autopsy findings demonstrated bilateral capsular and tegmental demyelinating lesions. In addition to this unusual aetiology, this is the first report with pathological evidence of a locked-in syndrome due to lesions outside the ventral brainstem.
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PMID:Reversible capsulo-tegmental locked-in state as first manifestation of multiple sclerosis. 368 27

Communicating syringes confined to the brain stem are extraordinarily rare. Two patients, presenting with signs and symptoms of cerebellar dysfunction, later developed evidence of brain-stem disease with dysarthria, nystagmus, deafness, and internuclear ophthalmoplegia. The condition of both patients had been diagnosed clinically as multiple sclerosis, but at autopsy they had a striking keyhole-shaped syrinx in the midbrain and upper pons, which communicated with the aqueduct and fourth ventricle without associated syringomyelia. In addition, both patients had marked atrophy and gliosis of the cerebellum, one with extension of the syrinx into cerebellar folia. The unique character of these lesions coupled with the similarity of the clinical features of the cases prompted us to name this disorder--"keyhole aqueduct syndrome."
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PMID:Keyhole aqueduct syndrome. 374 Dec 9

Three patients with focal brain-stem oculomotor disturbances (nuclear sixth nerve syndrome, sixth nerve palsy, bilateral internuclear ophthalmoplegia) as a consequence of multiple sclerosis have been studied with high-volume delayed computed tomography and high-field magnetic resonance imaging. In all of them, high-volume delayed computed tomography was inconclusive in the brain stem, but magnetic resonance imaging showed an area of prolonged T1 and/or T2 in the region appropriate to the oculomotor findings. Magnetic resonance imaging is the imaging technique of choice of small plaques in the brain stem. It can considerably aid clinicotopographic correlation in multiple sclerosis.
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PMID:Correlates of brain-stem oculomotor disorders in multiple sclerosis. Magnetic resonance imaging. 396 12

The eye movements of 100 patients with multiple sclerosis were examined clinically, including a saccade test. Thirty-four cases of internuclear ophthalmoplegia were found, of which 14 were bilateral and 20 were unilateral. Only three patients had full restriction of adduction, whereas 16 had no restriction at all. A continuous dissociated nystagmus was present in one patient only, while in 15 just a few beats of the abducting eye could be observed. In ten cases both restriction of adduction and dissociated nystagmus were lacking, and the diagnosis could only be made with the saccade test, which in all 34 patients showed a clearly visible disjunction of horizontal saccades. In 15 cases, infrared oculography was performed, which in all cases confirmed the clinical findings, and which in some cases disclosed an additional subclinical internuclear ophthalmoplegia on the opposite side.
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PMID:The clinical spectrum of internuclear ophthalmoplegia in multiple sclerosis. 402 28


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