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 case of fungal aneurysm associated with presumed Tolosa-Hunt syndrome is reported. A 57-year-old man was admitted to our hospital with complaints of left blepharoptosis, headache and weight loss. Neurological examination revealed left ophthalmoplegia without facial hypesthesia. Visual acuity was normal. Laboratory studies showed raised ESR, 4+ glycosuria, and a blood sugar of 351mg/dl. Computerized tomography (CT) scan and left carotid angiography were considered normal. Left orbital venography showed no filling of the left cavernous sinus. Diabetic ophthalmoplegia was suspected by a neurologist. The patient was treated with insulin therapy, but visual acuity worsened, and hypesthesia was noted in the first and second divisions of the left trigeminal nerve. Subsequent CT scan demonstrated a high density lesion, which was homogeneously enhanced, in the left cavernous portion and the superior orbital fissure. The patient was presumed of Tolosa-Hunt syndrome, and prednine therapy (30mg/day) was started. On the second day after the administration of prednine, hypesthesia of the first and second division of the left trigeminal nerve improved. After 9 days of prednine therapy, the patient suddenly complained of severe headache, and lapsed into a coma. Massive hemorrhage with subarachnoid hemorrhage was recognized on the CT scan, with a marked midline shift to the right. The hematoma was immediately removed. A ruptured cerebral aneurysm was found at the bottom of the hematoma. The aneurysm was located in the distal portion of the left middle cerebral artery. Aneurysm clipping with external decompression and bilateral ventricular drainage was performed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A fungal aneurysm in a patient with presumed Tolosa-Hunt syndrome]. 185 58

In the past, angiography was performed in all patients as part of the initial workup for isolated oculomotor paralysis, except patients older than 40 years with pupillary sparing. The pupil-sparing group was not subjected to angiography because of a low probability of cerebral aneurysm. It is believed that the case reported here constitutes the lower age limit (14 years) for documented, isolated oculomotor paralysis due to aneurysm. It is recommended that an angiogram not be a necessary part of the workup of patients 10 years old or younger.
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PMID:Acute oculomotor nerve palsy in childhood. Is arteriography necessary? 252 43

A case of ophthalmoplegic migraine with cerebral aneurysm is reported. A 47-year-old female with a 17-year history of migraine was admitted. She had three attacks of severe migrainous headache accompanied with nausea and vomiting within three weeks. Soon after the third attack, she noticed diplopia and left blepharoptosis. Lumbar puncture revealed no hemorrhage but the cerebral angiogram demonstrated an aneurysm at the junction of the left internal carotid artery and the posterior communicating artery. Operation revealed that the oculomotor nerve was not compressed by the aneurysm. But the oculomotor nerve had an indentation produced by the posterior communicating artery at 1-2 mm distal to the midbrain. A piece of sponge was then inserted between the nerve and the responsible artery. After the operation, her oculomotor nerve palsy was gradually improved and she discharged with mild anisocoria. The exact pathogenesis of ophthalmoplegia in ophthalmoplegic migraine is still unknown. In our case, cross compression of the oculomotor nerve with dilated posterior communicating artery seemed to be the cause of ophthalmoplegia.
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PMID:[A case of ophthalmoplegic migraine with cerebral aneurysm]. 339 4