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

Successful identification of the cranial nerve and ocular muscle responsible for a subjective complaint of diplopia requires an evaluation of the type and character of the double vision and not infrequently the use of a red glass or Maddox rod, especially in incomplete and subtle cases. An isolated third nerve lesion is most commonly seen with a supraclinoid aneurysm (pupil dilated and fixed), vascular disease (pupil spared), and trauma. Mild frontal head trauma and vascular disease are the most common etiologies associated with an isolated fourth nerve paresis. Tumor, vascular disease and trauma should be prime considerations when a patient presents with an isolated sixth nerve paresis. A child's diagnostic possibilities will differ from the adult: third nerve (congenital), fourth nerve (congenital), and sixth nerve (brainstem glioma, postviral or inflammatory). Finally, myasthenia gravis can readily mask or mimic an isolated or mixed cranial nerve palsy. A Tensilon test is always indicated in unexplained diplopia with ophthalmoplegia and normal pupils.
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PMID:Paresis of cranial nerves III, IV, and VI: clinical manifestation and differential diagnosis. 248 13

We report the clinical and computed tomography findings in two patients with small mesencephalic hematomas. Both patients presented with unilateral oculomotor paralysis and minor associated neurological symptoms. One patient had pupillary involvement suggestive of a peripheral third nerve lesion. Computed tomography evaluation disclosed small unilateral anterior mesencephalic hematomas involving the oculomotor fascicle. Angiography in both cases and surgery in the first case disclosed no evidence of an arteriovenous malformation or neoplasm. Both patients showed significant clinical improvement within 3 months.
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PMID:Mesencephalic hemorrhage and third nerve palsy. 344 13

Orbital myositis is a subgroup of the nonspecific inflammatory syndrome or orbital pseudotumor and is characterized by a primary inflammation of extraocular muscles. The authors describe a 70-year-old patient with acute proptosis, ocular pain and right ophthalmoplegia, whose orbital computed tomographic scan showed enlargement of the homolateral extraocular muscles. Clinical presentation and complementary tests were compatible with the diagnosis of orbital myositis however, because of the particular aspects, which included retinal central vein occlusion, optic nerve lesion, distension of the superior ophthalmic vein and the homolateral cavernous sinus, the differential diagnosis with cavernous sinus pathology and thyroid ophthalmopathy was considered. The importance of a rapid diagnosis and treatment is stressed.
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PMID:[Orbital myositis]. 944 84

An 8-month-old boy presented with anisocoria, a sluggishly reactive right pupil, and cholinergic supersensitivity as the only signs of what proved months later to be compressive third cranial nerve palsy due to an arachnoid cyst. Tonic constriction and dilation, segmental iris sphincter palsy, aberrant regeneration phenomena, ductional deficits, and ptosis were absent. The initial diagnosis was postganglionic internal ophthalmoplegia attributed to a viral ciliary ganglionopathy. Nineteen months later, he had developed an incomitant exodeviation and a supraduction deficit. Brain MRI revealed a mass consistent with an arachnoid cyst compressing the third cranial nerve in the right interpeduncular cistern. Resection of the cyst led to a persistent complete third cranial nerve palsy. This is the second reported case of prolonged internal ophthalmoplegia in a young child as a manifestation of a compressive third cranial nerve palsy. Our patient serves as a reminder that isolated internal ophthalmoplegia with cholinergic supersensitivity is compatible with a preganglionic compressive third nerve lesion, particularly in a young child.
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PMID:Arachnoid cyst causing third cranial nerve palsy manifesting as isolated internal ophthalmoplegia and iris cholinergic supersensitivity. 1876 82