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)

Pseudotumor, Graves' disease, and lymphoproliferative disease are the most common ophthalmologic disease entities requiring evaluation by CT and MR imaging. A history of acute onset, pain, swelling, proptosis, and response to steroids are the classical findings. The radiologic findings are categorized according to location into dacryoadenitis, myositis, and sclerouveitis, with and without associated infiltrations. The inflammatory infiltrate, which is composed of polymorphic leukocytes, lymphocytes, and plasma cells interspersed with a variable amount of fibrovascular tissue, may be diffuse or localized. The preferred radiologic method used for assessment of pseudotumor is CT. MR imaging, however, is indicated for evaluation of the Tolosa-Hunt syndrome, which is characterized by an inflammatory infiltrate in the orbital apex and cavernous sinus leading to cranial nerve involvement with ophthalmoplegia. The clinical and radiologic constellation of findings allows a definitive diagnosis in most cases.
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PMID:Pseudotumor of the orbit. Clinical, pathologic, and radiologic evaluation. 1002 35

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

A 76-year-old man with herpetic vesicle in the right auricle developed ipsilateral 5th, 6th, 7th, and 8th cranial nerves involvement and pain in the dermatome of the second cervical nerve. The CSF study revealed elevated opening pressure up to 220 mmH2O, and pleocytosis up to 151 cells/mm3. Ninety-nine percent of the CSF cells were mononuclear cells. CSF protein was 47 mg/dl, and CSF glucose was 62 mg/dl. On the 24th hospital day the CSF cells decreased to 13/mm3 with 100% mononuclear cells. Titer of varicella-zoster virus (VZV) antibody was significantly elevated in CSF. Brain MRI and ABR demonstrated no abnormality. Although disorders of 5th and 6th cranial nerves and second cervical nerve improved, mild facial nerve palsy lasted and hearing disturbance showed no recovery. There are only seven cases of Ramsay Hunt syndrome associated with external ophthalmoplegia in the literature. However, un like the present case, none of these cases presented disorders of upper cervical nerves. In this case, we speculate that spreading of reactivated VZV caused local meningitis and multiple cranial nerve involvement as well as the second cervical nerve.
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PMID:[A case of Ramsay Hunt syndrome associated with local meningitis, multiple cranial neuropathy, and the second cervical nerve involvement]. 1039 78

In a typical case of pituitary apoplexy, a patient, who may or may not be known to harbor a pituitary adenoma, suddenly develops a severe headache. The headache may be retro-orbital, frontal, frontotemporal, or diffuse and may be associated with neck stiffness, neck pain, or both. Ophthalmoplegia may develop within a few hours after the onset of headache. Here we report a rare case of one middle-aged female with pituitary apoplexy initially presenting with acute onset of pupil-involved third cranial nerve palsy, headache and peri-ocular pain. Emergent neuroimaging revealed pituitary apoplexy and immediate intravenous corticosteroid was given and third nerve paresis was improved thereafter. Definite tumor removal was done smoothly after steroid treatment and complete recovery of ophthalmoplegia was noted 2 weeks after operation.
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PMID:Acute painful oculomotor nerve paresis caused by pituitary apoplexy--a case report. 1046 26

A 47-year-old woman presented with severe neutropenia accompanied by diplopia and orbital pain. Her bone marrow was normal except for the absence of segmented neutrophils. Because the administration of granulocyte colony-stimulating factor (G-CSF) at a dose of 1 microgram/kg/day was not sufficiently effective and neutropenia developed, the patient was admitted to our hospital. Physical examination revealed painful ophthalmoplegia and hypoalgesia in the first region of trigeminal nerve, suggestive of Tolosa-Hunt syndrome. Severe neutropenia was observed in both peripheral blood and bone marrow, together with mild anemia and thrombocytopenia. The life span of red cells and platelets was shortened. High PAIgG levels, a positive Coombs test, and a positive test for anti-NA1 antibody suggested that blood cells were being destroyed by an autoimmune mechanism. Corticosteroid hormone therapy preceded by the administration of G-CSF at 5 micrograms/kg/day was effective for both neutropenia and in improving the patient's neurological findings.
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PMID:[Autoimmune neutropenia accompanied by Tolosa-Hunt syndrome]. 1062 27

Ten patients (6F, 4M) with recurrent Tolosa-Hunt syndrome are reported. Besides ocular motor symptoms, one patient had trigeminal nerve involvement, one had ipsilateral ocular sympathicoplegia with miosis and ptosis, and one tinnitus during an episode of Tolosa-Hunt syndrome, ipsilateral to the pain side. One patient had Bell's palsy, one had a possible Raeder's syndrome, and one had a period of tinnitus between the Tolosa-Hunt syndrome episodes. Three of the 10 patients reported periods of periocular pain without ophthalmoplegia between the Tolosa-Hunt episodes, the pain located ipsilateral to the ophthalmoplegic side in the Tolosa-Hunt episodes. Systemic symptoms associated with Tolosa-Hunt syndrome, e.g., back pain, chronic fatigue, arthralgia, gut problems among others, occurred with the same frequency in these 10 patients as in an earlier report. Seventy per cent of the patients had signs of inflammation in serum during a period of Tolosa-Hunt syndrome. Orbital phlebograms showed pathologic signs in four of the five patients investigated during a Tolosa-Hunt period. One phlebogram was normal in a sixth patient when performed during a period of unilateral periocular pain without ophthalmolegia. Magnetic resonance imaging of the head (with contrast) was only performed in three patients during the Tolosa-Hunt period: one showed signs of inflammation in the middle fossa and two were normal. In one of the patients with normal magnetic resonance imaging, the orbital phlebogram was pathologic. Steroid treatment promptly relieved the pain in all patients.
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PMID:Recurrent Tolosa-Hunt syndrome: a report of ten new cases. 1066 17

The Tolosa-Hunt syndrome consists of a painful ophthalmoplegia related to a granulomatous inflammatory process in the cavernous sinus, which may be documented by cerebral magnetic resonance imaging with gadolinium enhancement. Two cases of Tolosa-Hunt syndrome preceded by facial palsy observed in 1998 at the Department of Neurosurgery of the Second University of Naples are presented here. Both patients developed Tolosa-Hunt syndrome following an ipsilateral facial palsy that resolved in about 15 days with medical treatment. Cerebral magnetic resonance imaging with gadolinium enhancement showed, in both cases, inflammatory tissue in the cavernous sinus. The patients underwent corticosteroid therapy (prednisolone, 80 mg per day, intravenously) with pain regression. In the first case, the patient experienced recurrence of the syndrome that was definitively resolved with further corticosteroid treatment. The rare reports of facial palsy in patients with Tolosa-Hunt syndrome suggest the inclusion of this disease in the so-called multiple cranial nerve palsy syndrome. It is probable that Tolosa-Hunt syndrome has an inflammatory pathogenesis.
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PMID:Tolosa-Hunt syndrome preceded by facial palsy. 1084 35

Orbital infarction syndrome is defined as ischemia of all intraorbital and intraocular structures. It is a rare disease caused by rich anastomotic vascularization of the orbit. It can occur secondary to different conditions, such as, acute perfusion failure, systemic vasculitis, orbital cellulitis and vasculitis. It results in orbital and ocular pain, total ophthalmoplegia, anterior and posterior segment ischemia, and acute blindness. We report here upon two cases of orbital infarction with similar presentations but with different causes, namely, mucormycosis and as a postoperative complication of intracranial aneurysm, discuss the possible mechanisms of orbital infarction, and present a review of the literature on the topic. The prompt recognition of clinical pictures and rapid diagnosis is essential for the early treatment of orbital infarction, since its progression is very rapid and it can be even fatal.
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PMID:Two cases of orbital infarction syndrome. 1121 34

The causes of ophthalmoplegia in 24 consecutive patients with neurologically isolated, relative pupil-sparing third nerve palsy included infarction in 10 patients, compression by tumors or aneurysms in 10 patients, and miscellaneous disorders in four patients. There was no significant difference in the proportion of patients with pain, degree of external ophthalmoplegia, or degree of internal ophthalmoplegia between the groups with infarction or mass lesions. Therefore, screening for mass lesions using neuroimaging is indicated in patients with this presentation of third nerve palsy.
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PMID:Relative pupil-sparing third nerve palsy: etiology and clinical variables predictive of a mass. 1170 36

We report a 38-year-old woman who developed what appeared to be Fisher syndrome associated with optic nerve involvement. One week after a common cold, she developed double vision and left facial palsy. Four days after the onset, she developed bilateral blurred vision, painful total ophthalmoplegia, and ataxic gait. Brain CT and MRI findings were normal. Her vision worsened but the optic fundi were normal. Serum anti-GQ 1 b antibody was elevated. She received steroid therapy at another hospital, and her vision, facial palsy and ocular pain improved. She was transferred to our hospital and we treated her by plasma exchange. She showed near complete recovery. Human optic and ocular nerves contain high amount of GQ 1 b. This may be a underlying mechanism for optic nerve involvement in Fisher syndrome. We thought that she had an atypical Fisher syndrome associated with optic nerve involvement.
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PMID:[Atypical Fisher syndrome with optic nerve involvement]. 1143 43


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