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)

This paper reports 2 cases of the Tolosa-Hunt Syndrome and reviews 70 other cases reported in the literature. Common findings of this syndrome are the recurring painful ophthalmoplegia affecting the 3rd, 4th and 6th cranial nerve, as well as the first branch of the 5th and the optic nerve. No ethiologic factor has so far been found, but is regarded as a non specific inflammation in the area of the sinus cavernosus and adjacent orbital bone. Residual defects in about one third of affected persons is the normal course of the disease. Early diagnosis and initiation of steroid therapy results in quick relief of pain and may influence prognosis.
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PMID:[The Tolosa-Hunt syndrome (author's transl)]. 24 44

Of 185 patients with myopathy, 22 showed abnormal muscle mitochondria. In 12 of the 22 patients, all of whom had ocular myopathy or the ophthalmoplegia-plus syndrome, muscle biopsies contained 5%-25% "ragged red" fibers. In 4 patients with a facioscapulohumeral distribution of weakness, ragged red fibers were less numerous (3%-8%). In both groups, routine histology showed almost normal muscle. The remaining 6 patients were clinically heterogeneous, all without ptosis or ophthalmoplegia. The biopsies of three of these patients showed severely affected muscle. It is possible that mitochondrial changes in these muscles were nonspecific. Electromyography indicated or suggested a myogenic lesion in 21 of the 22 patients; in 10, the serum creatine kinase was increased.
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PMID:Myopathies with abnormal mitochondria: a clinicopathologic classification. 26 80

Seven patients with acquired ptosis were treated with a tuck in the aponeurosis of the levator palpebrae superioris muscle. Although the etiology for the ptosis was not always clear, associated conditions included progressive external ophthalmoplegia, prior ocular irradiation, prior ocular surgery and enucleation. One patient with progressive external ophthalmoplegia had good functional results. All of the other patients had good cosmetic, as well as good functional results. Since local infiltrative anesthesia was used, patients were able to cooperate during surgery by elevating and lowering their eyelids. The amount of tuck necessary to sufficiently elevate the eyelid could therefore be determined at surgery. The amount of lid elevation attained at surgery closely resembled the final postoperative result.
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PMID:Levator aponeurosis tuck: a treatment for ptosis. 26 96

Four examples of false negative diagnoses in computer tomography are discussed. The patients were suffering from tumours in the sella turcica, beside the sella turcica and in the cerebellopontine angle. With reference to the two patients with a process beside the sella turcica, the differential diagnosis of these processes (of which the clinical syndrome is characterized by ophthalmoplegia) is discussed. The diagnostic reliability of computer tomography seems to be inferior for these perisellar processes than for other localizations. Angiography and pneumoencephalography are the methods of choice in the diagnosis of these processes.
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PMID:[Some examples of false negative diagnoses in computer tomography (author's transl)]. 30 Aug 87

Two women, one with Hodgkin's disease and the other with no malignancy, developed herpes zoster with optic neuropathy and total ophthalmoplegia. Both patients developed an associated mild meningoencephalitis with a predominantly lymphocytic spinal fluid reaction that cleared spontaneously. The patient with Hodgkin's disease suffered a protracted course of the disease and developed a secondary bacterial endophthalmitis that necessitated an envisceration of the left eye. The patient without evidence of immunologic deficit recovered quickly with administration of corticosteroids.
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PMID:Orbital apex syndrome secondary to herpes zoster ophthalmicus. 30 54

A case of exophthalmic myositis was identified by a secondary herpes zoster exacerbation. The herpes zoster exophthalmus in this case remained - in contrast to all other cases so far published - free of signs of ophthalmoplegia and retrobulbar neuritis with visual acuity loss.
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PMID:[Herpes zoster-exophthalmus without ophthalmoplegia (author's transl)]. 31 75

A left infraclinoid carotid aneurysm (3 x 2-5 x 2 cm) in a 60-year old woman presented with total ophthalmoplegia and trigeminal symptoms. A staged internal carotied occlusion in the neck was performed using a SALIBI-clamp. A chronic infectious fistula developed (Klebsiella aerogenes). When superficial debridement failed, operative removal of the SALIBI-clamp was planned seven months after its insertion. The clamp was found subcutaneously without any relation to the internal carotid artery and was easily removed. Subsequent catheter angiography proved the left internal carotied to be completely occluded in the neck. No cross filling of the aneurysm could be demonstrated from the right carotied nor the vertebro-basilar arteries. The neurological deficit remained unchanged. The wound closed promptly without further signs of infection.
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PMID:Explusion of SALIBI-clamp from the internal carotied artery in the neck by infection. 33 3

Cerebro-rhino-orbital phycomycosis (CROP) occurs predominantly in individuals with diabetes mellitus in a state of metabolic acidosis. Other forms of metabolic acidosis, especially in infants, may predispose to phycomycotic infections. CROP has also been reported in patients with leukemia or lymphoma. CROP usually begins in the palate or paranasal sinuses and rapidly spreads to the orbital contents. Proptosis, loss of vision, and ophthalmoplegia occur and death from cerebral involvement commonly ensues. The fungus tends to invade arteries and cause thrombosis and tissue infarction. Rhizopus is the most commonly isolated genus in CROP, accounting for almost all cases. The diagnosis can be strongly suspected by the characteristic clinical manifestations. Therapy includes treatment of the underlying disease, surgical excision of the necrotic tissue containing fungal elements and the systemic administration of amphotericin-B. The effect of treatment has improved since the disease was first described, but the condition still has a high mortality, especially if it is not diagnosed early.
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PMID:Ocular and orbital phycomycosis. 33 48

The potential for using CT to diagnose orbital lesions is clearly demonstrated in this chapter. The patients discussed were all suffering from proptosis and had other complaints such as visual disturbances, pain, or ophthalmoplegia. CT is superior to ultrasonography in its ability to reproduce anatomical structures, including the retroocular space, bony walls of the orbit, and extraorbital regions, such as ethmoid sinuses and the cranial cavity. Such reproduction helps distinguish lesions arising within the orbit from those invading the orbit from outside. CT not only defines the extent of a lesion but also provides information about the physical properties of the tissue. The remarkable difference on CT between proptosis caused by thyrotoxic disease and that caused by intraorbital tumor or pseudotumor is a striking example of the way in which CT may contribute to more accurate diagnosis.
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PMID:Computerized tomography of the orbit. 34 4

A 9-year-old boy presented with symptoms and signs of marked postganglionic cholinergic autonomic dysfunction manifested by bilateral internal ophthalmoplegia, impaired secretion of tears and saliva, lack of gastrointestinal motility, atony of the bladder, generalized absence of sweating, and hypertension. Clinical and pharmacological studies confirmed that the abnormalities were restricted mainly to the postganglionic cholinergic autonomic system and showed evidence of postdenervation supersensitivity to parasympathomimetic drugs. The patient was treated in the early phase of his illness by the administration of carbachol, and eventually he made a slow and partial spontaneous recovery. Histoimmunofluorescent studies on a skin biopsy specimen suggested an autoimmune origin for his disease, with IgG antibodies being produced against postganglionic cholinergic autonomic fibers.
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PMID:Postganglionic cholinergic dysautonomia. 36 43


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