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)

The authors report on the case of a 32 year old woman treated with prednisone and diphenylsulfon for a multi-visceral sarcoidosis; headache and progressive oculomotor paralysis revealed an expansive lesion of the left cavernous sinus extending to the temporal fossa. C.T. scan, M.R.I., and angiographic data as well as the intra-operative findings evoked the diagnosis of meningioma. Pathological findings showed an epithelioid and gigantocellular granuloma without caseous necrosis, corresponding to a sarcoidosic lesion. After the operation, the increase of steroid doses was followed by a complete regression of the tumoral remnants, and total clinical recovery. In a patient having a previously diagnosed sarcoidosis with evidence of an intracranial tumor mimicking a meningioma, steroids should be first prescribed. Efficacy of steroids on sarcoid granulomas is often dramatic; surgical approach would be discussed in case of ineffective steroid therapy, of persisting questionnable diagnosis, and of tumoral threatening compression.
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PMID:[Sphenocavernous localization of meningeal neurosarcoidosis. Apropos of a case and review of the literature]. 824 16

Partial ophthalmoplegia due to third nerve palsy with an intact pupil is a frequent cause of diploplia observed in diabetic patients. Pupillary muscle involvement, such as anisocoria and loss of light reflex, is usually uncommon in this diabetic cranial mononeuropathy. A 65-year-old woman with non-insulin dependent diabetes mellitus (NIDDM) suddenly developed a severe headache and diplopla. Right oculomotor nerve palsy was observed in association with anisocoria, ptosis of the right lid, and a defective light reflex. No exophthalmos or vascular bruit was observed in the right orbital region. Computed tomography and magnetic resonance images of the head were negative. Cerebral angiography revealed a carotid cavernous sinus fistula (CCF). The patient was successfully treated with external carotid artery embolization combined with radiation. It is well known that pupil sparing in oculomotor nerve palsy predicts an extraaxial ischemic lesion, while pupil involvement predicts an extraaxial compression lesion. Therefore, pupillary involvement in oculomotor nerve palsy in diabetic patients necessitates cerebrovascular investigation to rule out ICPC aneurysm or tumor. In this circumstance, a variant type of CCF without characteristic ocular signs should be included in the differential diagnosis.
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PMID:[A case of NIDDM associated with oculomotor palsy due to atypical carotid cavernous sinus fistula]. 827 44

MRI using gadolinium contrast material can demonstrate lesions in cranial nerves. Tumors and inflammatory lesions have been described. There is little published information on MRI of cranial nerves in patients with migraine headaches with ophthalmoplegia. We present a case of ophthalmoplegic migraine with a cranial nerve abnormality which was subsequently shown to improve as the patient clinically improved. Implications from this finding are discussed in relation to the pathophysiology of ophthalmoplegic migraine.
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PMID:MRI findings in a case of ophthalmoplegic migraine. 832 96

A patient is described who simultaneously suffered from hallucinations and one-and-a-half syndrome following surgical resection of a cavernous angioma located on the fourth ventricle floor. A 30-year-old male was admitted having a 10 year history of progressive weakness and hypesthesia of the right extremities. Neurological examination revealed right hemiparesis and hemihypesthesia. A computerized tomography (CT) scan showed a well circumscribed mixed-density area at the left portion of the pontine tegmentum. Magnetic resonance imaging (MRI) indicated a mixed intensity core surrounded by hypointense regions on T2-weighted images. A red mulberry-like tumor was found, during surgical procedures, on the mid-and left-portion of the fourth ventricle floor. The tumor was totally resected and the histological diagnosis was cavernous angioma. Visual hallucinations occurred several times following surgery, being subsequently described as images of moving worms, a dump truck next to the bed, and a bed falling from the ceiling. The patient soon understood these objects were not real. He simultaneously exhibited left lateral gaze palsy associated with left internuclear ophthalmoplegia i.e., one-and-a-half syndrome. Three months after surgery the visual hallucinations disappeared but the one-and-a-half syndrome was incompletely resolved. According to the neurological signs and the MRI results, the lesion site was considered to extend from the left lower pons to the midbrain. Previously reported operations of cavernous angioma of the fourth ventricle floor are also described.
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PMID:[Appearance of hallucinations and one-and-a-half syndrome after resection of a cavernous angioma located in the fourth ventricle floor]. 845 3

Two cases of paraganglioma arising from the parasellar region are presented. Both occurred in middle-aged women who sought treatment of headaches but who had no endocrinological dysfunction; one case was associated with ophthalmoplegia from cavernous sinus involvement. Diagnosis in both cases was confirmed by typical histological appearance and cytochemical demonstration of immunoreactive chromogranin in tumor cells. The pathological features and possible pathogenesis of parasellar paragangliomas are discussed.
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PMID:Paragangliomas of the sellar region: report of two cases. 849 63

Wernicke's encephalopathy, neuropathy caused by a deficiency of thiamine is a syndrome characterized by memory troubles, mental confusion, ophthalmoplegia and nystagmus. The authors present a case that came up in a patient who underwent a subtotal gastrectomy because of malignant neoplasm of the stomach. More or less three months after the intervention the patient's general conditions were considerably declined and characterised by alimentary vomit, sensory obnubilation and neuromuscular deficit. After appropriate diagnostic ascertainments a repetition of the neoplastic disease was to be excluded locally and at a distance. So the authors analysed the different etiopathogenic possibilities to get a better clinical view of the syndrome in the surgical patient.
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PMID:Wernicke's encephalopathy post subtotal extended gastrectomy. 854 60

Cavernous sinus syndrome (CSS) is characterized by deficits in more than one of the cranial nerves (CN) that traverse the cavernous sinus at the base of the cranial vault: CN III (oculomotor), IV (trochlear), VI (abducens), and the first two branches of CN V (trigeminal). Records from 4 dogs and 8 cats with CSS diagnosed over a 14-year period were reviewed. The most common clinical signs were ophthalmoparesis or ophthalmoplegia, mydriasis with no direct or consensual pupillary light reflexes, ptosis, decreased corneal sensation, and decreased retractor oculi reflex. All cats had initial signs referable to a left CSS lesion (one had bilateral CSS), whereas in all dogs the lesions were localized to the right cavernous sinus. Median ages at diagnosis were 9 and 10 years of age for dogs and cats, respectively. Cerebel lomedullary cisternae cerebrospinal fluid analysis in 6 animals was useful as a sensitivebut nonspecific diagnostic test of an intracranial inflammatory or neoplastic lesion. Magnetic resonance imaging scans provided a more definitive diagnostic test in all dogs, revealing a contrast-enhancing mass on T1 weighted scans in the region of the cavernous sinus. A definitive pathological diagnosis was obtained in 2 dogs: a primary intracranial neoplasm and a metastatic intracranial neoplasm. A definitive diagnosis was obtained in 6 cats: metastatic neoplasm (n = 1), primary intracranial neoplasm (n = 1), primary intracranial infectious disease (n = 2), and associated systemic infectious disease (n = 2). The prognosis associated with CSS in dogs and cats was considered guarded to poor.
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PMID:A retrospective study of cavernous sinus syndrome in 4 dogs and 8 cats. 868 82

An 84-year-old female presented with bilateral giant intracavernous carotid artery aneurysms manifesting as right total ophthalmoplegia and trigeminal nerve paresis. Computed tomography and magnetic resonance imaging showed the two aneurysms as one fused mass, so the initial diagnosis was a parasellar tumor occupying the bilateral cavernous sinuses. The correct diagnosis required cerebral angiography. Considering her age, no surgical or interventional treatment was given. Eight months later, her right eye movement partially recovered and she had no further symptoms. There was no definite causative factors other than aging in this case.
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PMID:Bilateral giant intracavernous carotid artery aneurysms mimicking a cavernous sinus neoplasm--case report. 883 Dec 2

The authors report 4-year follow-up results for their first 15 consecutive tumor patients, who underwent transconjunctival surgery of their orbital lesions without muscle dissection. Presentation, natural history, management, surgical appraisal of the transconjunctival approach and its indications are discussed. At follow-up, 14 of the patients showed excellent cosmetic and functional results. Our experience with the transconjunctival approach in the past 4 years suggests that this approach remains a useful modality, with good intraoperative visibility and minimal postoperative scar formation, for managing selected patients with space-occupying lesions located in the inferior medial and basal compartment of the orbit. Not suitable for the transconjunctival approach are deep intraconal lesions (orbital apex) and extraconal superior lesions. The rare problems with the transconjunctival approach have included temporary eye muscle injury with ophthalmoplegia postoperatively. More recently, the use of the transconjunctival approach has allowed surgeons to reduce cosmetic failures, functional deficits and deformities of the orbit. Because of its low risks, the absence of postoperative bleeding, and the absence of prolongation of hospitalization or immobilization of the patients, the transconjunctival approach is a successful procedure, especially in elderly multimorbid patients.
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PMID:[Microsurgical transconjunctival approach to the orbits. Initial retrospective analysis of experiences with the transconjunctival approach in 15 patients. Clinical and surgical aspects]. 900 91

A 75-year-old male with left abducens nerve paresis presented with an ectopic pituitary adenoma invading the posterior wall of the sphenoid sinus. The sphenoidal mass grew rapidly for 6 months with left ophthalmoplegia and was partially removed via the transsphenoidal approach. The histological examination showed a benign pituitary adenoma, but the MIB-1 proliferating cell index was 6.8%, reflecting the clinically malignant behavior. The symptom gradually improved without tumor regrowth over 1.5 years after conventional irradiation.
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PMID:Rapidly-growing ectopic pituitary adenoma within the sphenoid sinus--case report. 918 38


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