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

Primary teratomas rarely occur in the orbit leading to major exophthalmia in the neonate. We report a case in a female infant who presented globular right exophthalmia extending beyond the orbit caused by a teratoma of the orbit. There was right ophthalmoplegia. Computed tomography showed enlargement of the orbit without modification of the bony structure despite the tumor volume. Tumoral enucleation was performed via the transconjunctive route. Histology reported benign mature multi-tissue teratoma. The postoperative course was uneventful. The CT-scan at 6 months evidence the absence of recurrence, outcome which has been confirmed after a 5-years follow-up.
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PMID:[Primary teratoma of the orbit. Apropos of a case]. 927 81

The case history of a 54-year-old male suffering from pituitary macroadenoma with suprasellar extension is reported. A TRH-test with 200 micrograms i.v. was followed by severe headache and vomiting after 60', and by development of ophthalmoplegia on the following day. Hyperdens patches on the CT scan showed haemorrhage into the tumor. A chromophobic adenoma with macroscopic and histological signs of haemorrhage was removed via the transsphenoidal route. In the postoperative period the ophthalmoplegia gradually disappeared but central hypoadrenia and hypothyroidism occurred. This is the second case in the literature showing that TRH alone and in a low dose may cause pituitary tumor apoplexy. It is concluded that TRH-testing is a risk for the patient with pituitary apoplexy. If, due to the size of the tumor the patients have to be operated on in any case, and the test is not of essential diagnostic value, the TRH-test should be done only in selected cases. Its use in the postoperative evaluation however is without risk for the patients.
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PMID:Apoplexy of a pituitary macroadenoma as a severe complication of preoperative thyrotropin-releasing hormone (TRH) testing. 928 12

Cutaneous carcinomas of the face, and some nasopharyngeal carcinomas, may present with facial dysesthesias and/or facial nerve palsies in the absence of visible masses. Even with frank ophthalmoplegia, occult tumors that present in this matter may elude detection, for which reason specific diagnostic studies must be employed. We report seven cases of trigeminal nerve infiltration by occult tumors (five squamous cell carcinomas, one basal cell carcinoma, and one adenoid cystic carcinoma), and outline the clinical course, diagnostic investigations, and the subsequent management of these patients. The importance of establishing an early diagnosis before the tumor has transgressed the basal foramina is emphasized, as tumor infiltration of the cavernous sinus carries a more guarded prognosis. The use of magnetic resonance imaging to identify involved peripheral nerve branches that may then be biopsied is suggested. The patho-physiological mechanisms of neurotropic spread of tumor are reviewed.
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PMID:Occult perineural tumor infiltration of the trigeminal nerve. Diagnostic considerations. 930 29

The Tolosa-Hunt syndrome (THS) consists of a painful ophthalmoplegia related to granulomatous inflammatory process in the cavernous sinus. According to recent concepts, the diagnosis is established only when other causes of painful ophthalmoplegia are ruled out. A typical pattern of response to corticosteroids associated with a benign evolution may reinforce this possibility. Tumors such as lymphoma and meningioma and orbital pseudotumors can make difficult the differential diagnosis because they also may respond to steroids. Thus it is always necessary to make an extensive ancillary investigation. We performed a clinical, laboratory and radiologic study of five patients with THS. Prednisone was used in all, with dosages ranging from 40 to 80 mg/day. In four patients there was a dramatic analgesic effect in less than 48 hours. Improvement of the ophthalmoplegia was not so fast but occurred in all with a complete remission in 4 to 45 days.
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PMID:[Tolosa-Hunt syndrome. Troubles in diagnosis and pattern of response to prednisone]. 933 68

A 28-year-old man had recurrent episodes of headache, ophthalmoplegia, and ptosis. MR imaging showed a mass within the sphenoid sinus. TI-201 imaging showed intense uptake in the region of the sphenoid sinus and right middle fossa with moderate retention of activity, suggesting the diagnosis of a viable tumor. A biopsy specimen from the sphenoid sinus revealed dense inflammatory infiltrate dominated by plasma cells, consistent with inflammatory pseudotumor. After radiation therapy, the mass showed no significant change on MR imaging, but regressed in size and uptake on the follow-up TI-201 scan. TI-201 may accumulate in nonmalignant inflammatory lesions and could mimic a viable tumor. It is, therefore, suggested that before surgery and histologic diagnosis, any abnormal intracranial accumulation of TI-201 should be interpreted with caution.
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PMID:False-positive uptake of TI-201 by an intracranial inflammatory pseudotumor. 936 83

A case is presented of metastatic tumor causing Jacod's syndrome: total ophthalmoplegia, blindness, and trigeminal neuralgia. Abnormal soft tissue invading the orbital apex, anterior clinoid process, and cavernous sinus was difficult to assess by CT and MRI, but dual-isotope SPECT including Tc-99m HMDP bone imaging and Tl-201 tumor imaging strongly suggested that the cause of this rare syndrome was a small metastatic tumor. Although the therapeutic effect was also difficult to assess by anatomic imaging alone, dual-isotope SPECT after radiation therapy showed a decline of tumor viability.
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PMID:Dual isotope SPECT in malignant Jacod's syndrome. 967 48

Wernicke's encephalopathy is an uncommon disorder caused by a thiamine deficiency which is clinically characterized by the triad of ophthalmoplegia, ataxia and disturbances of consciousness, each finding being variably present. The disease is caused by malnutrition or malabsorption, and is often associated with prolonged alcohol intake, neoplasm and extensive inflammatory processes of the digestive tract and parenteral hyperalimentation-induced gastrointestinal mucosal atrophy. Clinical diagnosis can be elusive and MRI may be the only imaging technique able to detect the cerebral lesions, whose type and distribution are characteristic of the Wernicke's encephalopathy, whereas CT is positive only in exceptional cases. We report a case of a 56-year-old woman who developed a Wernicke's encephalopathy 1 month after a colonic resection with signal intensity changes located in the mammillary bodies and in the medial thalamic nuclei.
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PMID:Magnetic resonance imaging in a case of Wernicke's encephalopathy. 968 4

Intracranial meningiomas in children are rare, representing 1-4.2% of central nervous system tumors and 1.5-1.8% of all intracranial meningiomas. Meningiomas arising from the lateral wall of the cavernous sinus account for less than 1% of all intracranial meningiomas. To our knowledge, only one case of a meningioma arising from the cavernous sinus has been reported in childhood. A 6-year-old boy presented with left ophthalmoplegia. A slight drooping of the left eyelid was noted at the age of 1 year. Magnetic resonance imaging (MRI) with contrast administration revealed an enhancing mass lesion located in the left cavernous sinus. The tumor, arising from the lateral wall of the cavernous sinus, was totally removed and the oculomotor nerve was reconstructed with a sural nerve graft. MRI displayed total tumor removal 1 month after the surgery. The pathological diagnosis was of a psammomatous meningioma.
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PMID:Meningioma of the cavernous sinus in a child. 1006 14

We report a 48-year-old female who presented limb-girdle type myasthenia gravis with inflammatory lung lesions and rheumatoid arthritis. She demonstrated a rapidly progressive muscle weakness of extremities. Neurological examination revealed facial muscle weakness, and proximal dominant limb muscle atrophy and weakness. Ptosis, ophthalmoplegia, and bulbar palsy were not observed. The edrophonium test and serum anti-acetylcholine receptor antibody were positive. The repetitive nerve stimulation showed 55% waning in the thenar muscles. From these findings, she was diagnosed as having myasthenia gravis. Plain chest X-P and body CT showed tumor-like lesions in the lung. Lung biopsy revealed the infiltration of lymphocytes. These lesions decreased in size after thymectomy and corticosteroid administration. Immediately after thymectomy, she began to have morning stiffness with pain and swelling of the finger and knee joints. RAHA test, which was negative before thymectomy, became highly positive. These findings were consistent with rheumatoid arthritis. In this patient, thymus probably played a role to suppress the development of rheumatoid arthritis.
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PMID:[A case of limb-girdle type myasthenia gravis in whom rheumatoid arthritis appeared immediately after thymectomy]. 1039 Oct 80

The paper describes a clinical observation of closure of sphenoidal sinus defect and plastic repair of dura mater by using orbital tissues after removal of a tumor from the medial portions of the middle cranial fossa, which spread into the orbit and sphenoidal sinus, in complete irreversible loss of visual function, ophthalmoplegia and ptosis in a patient with skull soft tissue hypotrophy due to multiple operations and radiation therapy and hence unsuitable for displacement and closure. This observation shows it possible to use orbital soft tissue for repair of the base of the skull, in cases when integumentary cranial tissues are impossible to use as a plastic material due to their hypotrophicity. At the same time severe dysfunctions, such as blindness and ophthalmoplegia enable orbital tissues to be employed without significantly deteriorating any functional and cosmetic effect.
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PMID:[Plastic repair of a defect in the base of the skull with soft tissues from the orbit after the removal of an extensive esthesioneuroepithelioma]. 1042 May 42


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