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 72-year-old female suffering from a histologically proven myeloma of the clivus exhibited an eye movement disorder closely resembling a bilateral internuclear ophthalmoplegia. The pertinent clinical findings suggested a peripheral lesions involving both oculomotor nerves. It is discussed under which circumstances an infranuclear lesion can simulate a supranuclear disorder of eye motility.
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PMID:[Pseudo-internuclear ophthalmoplegia in a case of myeloma of clivus (author's transl)]. 54 97

The eye movements of 25 patients with internuclear ophthalmoplegia were recorded by electrooculography. The velocity of adducting saccades was markedly less than normal. The velocity of abducting saccades was within the normal range, but statistically there was a wider distribution. Recordings were made in 2 patients several months after the onset of internuclear ophthalmoplegia, at which time the adducting eye velocity was greater than the abducting eye velocity. A patient with a unilateral medial fasciculus lesion showed marked overshoot of the abducting eye on contralateral saccades and overshoot of both eyes toward the side of the lesion. Optokinetic and postcaloric nystagmus were recorded, and the slow phase showed increasing velocity exponential waveform for the abducting eye. The recordings also showed decreasing velocity exponential waveform for the abducting eye. Downbeat nystagmus was as common as upbeat nystagmus in our patients. The findings appear to confirm the theoretical analysis of the eye movement disorder in internuclear ophthalmoplegia provided by Pola and Robinson as modified by recent experimental work in primates.
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PMID:An electrooculographic study of internuclear ophthalmoplegia. 61 77

Two middle-aged patients with motor neuron disease showed common eye movement disorders and intellectual impairment in the later stage of the illness. Eye movement disorders were characterized by slow saccades and vertical glaze palsy, which seemed to be supranuclear ophthalmoplegia. Neuropathological examination of one patient revealed degeneration of the substantia nigra without pathological changes in the ocular motor nuclei, in addition to findings compatible with motor neuron disease. These cases appear to raise a possibility of a distinct group of multiple system degenerations.
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PMID:Motor neuron disease with slow eye movements and vertical gaze palsy. 154 38

Horizontal saccadic and smooth pursuit eye movements were studied in 84 patients with multiple sclerosis (MS) and 21 patients with optic neuritis (ON). The MS patients were clinically classified as 'definite', 'probable', or 'possible'; subclinical eye movement disorder was found in 80 per cent of the definite, 74 per cent of the probable and 60 per cent of the possible category. Five of the ON patients (25 per cent) showed a subclinical eye movement deficit; these 5 were young patients with a recent history of ON. In a group of 27 MS patients with symptoms of spinal cord involvement only, 14 showed subclinical oculomotor disorder indicating the involvement of cerebral structures in the demyelination process. A study of the correlation between specific eye movement parameters and results of visual evoked response (VER) tests revealed that saccadic latency or smooth pursuit abnormalities are not correlated with prolonged VER latencies (P-100 peak latency). This indicates that lesions beyond the primary visual pathway contribute substantially to both parameters of oculomotor dysfunction. A significant correlation was found between prolonged saccadic latency and smooth pursuit deficit. An explanation for this finding based on functional aspects of the saccadic and smooth pursuit systems and their mutual interaction is presented. The occurrence of internuclear ophthalmoplegia (INO) is significantly related to an increase of saccadic latency. This finding indicates that demyelination in the patients manifesting INO may not be restricted exclusively to one or both medial longitudinal fasciculi, but may extend to other brainstem structures which are functionally involved in the programming of saccades. The findings confirm the value of standardized objective examination of eye movements in the detection and clarification of subclinical lesions in the central nervous system of patients with an early diagnosis of MS or ON.
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PMID:Eye movement disorders in multiple sclerosis and optic neuritis. 683 Nov 94

We investigated the reliability of a new digital post-processing magnetic resonance imaging (MRI) technique in ischemic brain stem lesions to identify relations of the lesion to anatomical brain stem structures. The target was a medial longitudinal fasciculus (MLF) lesion, which was evident from ipsilateral internuclear ophthalmoplegia (INO). Sixteen patients with acute unilateral INO and an isolated acute brain stem lesion in T2- and EPI-diffusion weighted MRI within 2 days after the onset of symptoms were studied. The MRI slice direction was parallel and perpendicular to a slice selection of a stereotactic anatomical atlas. The individual slices were normalized and projected in the digitalized atlas. The eye movement disorder was monitored by electro-oculography. In all patients with clinical or subclinical electro-oculographically documented INO and MRI proven brain stem infarction the lesion covered or at least partially overlapped the ipsilateral MLF at one or more atlas levels. We conclude that digital post-processing MRI with normalizing and projecting brain stem lesions in an anatomical atlas is a reliable method to demonstrate the anatomical structures involved by the lesion. Combined with electrophysiological brain stem testing, this method may be a useful tool to identify incompletely understood pathways mediating brain stem reflexes or the generators of evoked potentials.
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PMID:A new method to investigate brain stem structural-functional correlations using digital post-processing MRI--reliability in ischemic internuclear ophthalmoplegia. 1155 15

A 52-year-old patient developed an eye movement disorder first resembling a left internuclear ophthalmoplegia and subsequently a "one-and-a-half syndrome" as the presenting symptoms of ocular myasthenia gravis. No accompanying myasthenic features were present except for the fluctuation in the amplitude of dissociated nystagmus. This patient shows that an oculomotor disorder considered a typical pontine lesion may instead be caused by myasthenia gravis, even in the absence of other clinical and electrophysiologic features of neuromuscular deficit.
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PMID:Ocular myasthenia mimicking a one-and-a-half syndrome. 1172 88

Neuro-otologic examination is very important in evaluation of balance system. Multiple sclerosis (MS) is the most common chronic, debilitating disease characterized by focal demyelinization that develop throughout of the central nerves system at varying time. Patients with MS presented various complaints and signs, so the aim of the study was the neuro-otologic presentation of multiple findings in patients with MS and comparison with reviewing literature. The study was carried out in 32 patients with MS (21 with relapsing-remitting, 9 with secondary progressive, 1 with primary progressive and 1 with progressive/relapsing types) the mean age was 38 +/- 10 years. Clinical neuro-otologic examinations were performed in all patients paying special attention to eye movement ability. Vertigo as the first symptom was found in 18.8% of patients but up to 68% of patients would complain this symptom at some point of disease. The hearing impairment and tinnitus complains 6.2% patients, optic neuritis 28% patients and double vision 46.9% of them. A few types of eye movement disorder like abnormalities of fixation, gaze-evoked nystagmus, acquired pendular nystagmus and vertical nystagmus in 46.8% patients were observed. The clinical signs of internuclear ophthalmoplegia were noticed in 2 patients. Disturbance in voluntary gaze either in smooth pursuit test (31.3%) and in saccadic test (43.8%) were seen. The multifocal nature of MS explain why this disease are so commonly subject to defect different part of nerve system. Careful neuro-otologic assessment of every patient with MS is necessary to confirm and monitoring the course of disease.
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PMID:[Neuro-otologic findings in multiple sclerosis]. 1635 94

Eye movement disorders are rarely reported in vitamin B12 deficiency. We describe two cases with eye movement disorder and vitamin B12 deficiency; one with bilateral internuclear ophthalmoplegia and the other with downbeat nystagmus. Both of the patients received replacement therapy but their eye movement disorders did not respond to treatment. We also review the nine previously reported cases.
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PMID:Eye movement disorders in vitamin B12 deficiency: two new cases and a review of the literature. 1788 May 72

One-and-a-half syndrome is characterized by combination of the clinical features of unilateral horizontal gaze palsy and internuclear ophthalmoplegia. The common symptoms are double vision and oscillopsia. The lesion is located in the paramedian pontine reticular formation, involving the centre of horizontal gaze and medial longitudinal fasciculus. More extensive brainstem damage may result in additional neurological signs. The most frequent underlying diseases are vascular insults, multiple sclerosis, and brainstem tumor. We present two cases of one-and-a-half syndrome. Both patients had lacunar infarction in the paramedian pontine tegmentum, revealed by MRI. The first patient had isolated eye movement disorder, while the second had additional nuclear-type facial paresis. In the first case brainstem evoked potentials indicated brainstem damage, in the second patient it was normal. Ocular symptoms improved within some days in both patients.
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PMID:One-and-a-half syndrome--two cases. 1819 96

Horizontal eye movements are conducted by the medial rectus and the lateral rectus muscles, which are innervated by the oculomotor nerve (cranial nerve III) and the abducens nerve (cranial nerve VI), respectively. The oculomotor and the abducens nuclei are interconnected by a tract in the brainstem named the medial longitudinal fasciculus (MLF). Through the MLF, the actions of the oculomotor and the abducens nuclei are coordinated, generating conjugate horizontal eye movements. The disorders of horizontal eye movement that are caused by brainstem lesions are classified into three groups: (a) lateral gaze palsy, (b) internuclear ophthalmoplegia, and (c) one-and-a-half syndrome. Lateral gaze palsy is caused by a lesion involving the paramedian pontine reticular formation (PPRF) or the abducens nucleus. Internuclear ophthalmoplegia occurs as a result of a lesion involving the MLF. One-and-a-half syndrome is a combination of lateral gaze palsy and internuclear ophthalmoplegia and is caused by a lesion involving both (a) the ipsilateral PPRF or the ipsilateral abducens nucleus and (b) the ipsilateral MLF. The pathologic lesions depicted on magnetic resonance images were topographically well correlated with the brainstem pathways and each type of horizontal eye movement disorder. Most of the lesions were tiny acute infarctions and were found in the most posterior region of the pons, which corresponded to the location of the brainstem pathways. Therefore, awareness of the brainstem pathways controlling horizontal eye movement is important to avoid missing a small pontine lesion.
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PMID:Brainstem pathways for horizontal eye movement: pathologic correlation with MR imaging. 2332 26


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