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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In case of motility disturbances due to orbital fractures generally a vertical diplopia -- that means a vertical restriction of the motility of the globe -- is found. The classification into four types according to Friemel allows a differentiation between mechanical motility disturbances and those of other origin; furthermore a prediction can be made about the extent of the field of diplopia and about the involved position of gaze. In addition the urgency of a primary reconstruction of the orbit and the prognosis of a late eye muscle surgery can be estimated by this classification. It is of differential diagnostic importance that isolated injuries of the eye muscles and the check ligaments, an intraorbital haemorrhage and a subtotal paresis of the oculomotor nerve can show a similar clinical picture as usually found with orbital fractures. The early diagnosis of ocular motility disturbances caused by orbital trauma is of essential importance for the proper treatment and the recovery of binocular single vision.
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PMID:[Is there a typical motility disturbance in orbital wall fractures (author's transl)]. 720 82

A case of superior oblique paresis is presented which appeared to be due to cautherization of the superior oblique tendon. The torsional diplopia and head tilt were corrected with recession of the contralateral inferior rectus muscle.
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PMID:Superior oblique paresis after blepharoplasty. 740 15

A case of epidermoid carcinoma in the cerebello-pontine (CP) angle is presented. A 42-year-old male was admitted with a complaint of experiencing double vision for four months in January, 1992. During neurological examination, right abducens palsy, right facial dysesthesia, and atrophy of the right temporal muscle were noted. Magnetic resonance (MR) imaging revealed a mass of low intensity in the right CP angle, which was prominently enhanced with gadolinium. Malignancy was suspected because the tumor on MR enlarged rapidly in a month, so the first surgical resection was performed. Suboccipital exploration of the right CP angle was performed in February. At first, a fragile, pearly part of the mass typical of epidermoid was exposed behind the seventh and eighth cranial nerve complex. Then, a grayish, fibrous part was exposed, which involved the fifth cranial nerve and was attached to the tentorium and the brainstem. Histological diagnosis of the fragile part of the tumor revealed a typical epidermoid cyst and that of the fibrous part was squamous cell carcinoma. During postoperative examinations on other parts of the body, such as endoscopic studies of the trachea and the esophagus, no abnormality was shown. Therefore the tumor was diagnosed as a primary intracranial epidermoid carcinoma. Post-operatively, conventional fractionated external-beam focal irradiation was carried out, which caused regression of the residual tumor for eleven months. Subsequently, palsy of the right side of the tongue and paresis of the contralateral side of the extremities and face developed with increase of the right abducens palsy. MR imaging indicated regrowth of the tumor. The second operation via the subtemporal approach was unsuccessful, because the tumor was fibrous and firmly attached to the brainstem.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case report of epidermoid carcinoma in the cerebello-pontine angle]. 747

Three of 22 patients (14%) who underwent anterior temporal lobectomy for treatment of medically intractable epilepsy at our institution from July 1987 through July 1993 experienced diplopia immediately after surgery. We found ipsilateral paresis of the superior oblique muscle in all three patients. Their ophthalmoplegia resolved completely within 14 weeks. We did not observe any new structural or ischemic changes on postoperative MRIs to account for their deficits. Trochlear nerve palsy--not oculomotor nerve palsy, as is reported in most reference texts--is a relatively common cause of transient diplopia following temporal lobectomy. Indirect (ie, traction) injury of the trochlear nerve is a plausible mechanism that would explain this complication.
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PMID:Transient trochlear nerve palsy following anterior temporal lobectomy for epilepsy. 764 42

Diplopia in the reading position developed in two patients with unilateral Brown syndrome after a 7-millimeter section of #240 silicone retinal band was sewn between the cut ends of the superior oblique tendon at tenotomy. In both cases, forced ductions were positive, indicating a restrictive downgaze deficit. Surgical exploration revealed adhesions that prevented the normal sliding of the superior oblique tendon beneath the superior rectus muscle. Forced ductions became normal and downgaze improved after removal of the silicone band. Secondary superior oblique muscle paresis was also evident at the time of reoperation, requiring recession of the contralateral inferior rectus muscle (cases 1 and 2) and recession of the ipsilateral inferior oblique muscle (case 1). A restrictive downgaze deficit and a paretic overcorrection must be recognized as possible complications of the superior oblique tendon silicone "expander" operation.
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PMID:Downgaze restriction after placement of superior oblique tendon spacer for Brown syndrome. 775 31

A 49-year-old man who had been suffering from poorly controlled diabetes mellitus for 20 years was admitted to our hospital with the chief complaints of diplopia and right ptosis. The onset of his symptoms was sudden. On admission, he had right palpebral ptosis, upward and left lateral gaze paresis of the right eye. Hess screen chart examination revealed paresis of the right superior rectus, inferior oblique and medial rectus muscles. T2 weighted magnetic resonance imaging (MRI) revealed high intensity area in the medial part of the right midbrain tegmentum where the oculomotor nucleus located, and diffusion weighted MRI demonstrated high intensity area which corresponded to the oculomotor fascicles of the midbrain. The latter represented Wallerian degeneration of the fascicles. The diagnosis of small infarction of the right oculomotor nucleus presenting ipsilateral external ophthalmoplegia was made. The superior rectus muscle is innervated by the neurons in the contralateral oculomotor nucleus, and the other external ocular muscles innervated by the third cranial nerve are conducted by the neurons in the ipsilateral oculomotor nucleus; therefore, unilateral oculomotor nuclear lesion generally causes ipsilateral ophthalmoplegia plus contralateral superior rectus palsy. Our case presented here shows that there may be such a case with oculomotor nuclear disturbance which masquerades with oculomotor fascicular or infranuclear disturbance; therefore, it is important to include these lesions in differential diagnosis.
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PMID:[Unilateral external ophthalmoplegia caused by ipsilateral oculomotor nuclear lesion: analysis with diffusion weighted MRI]. 782 Sep 68

Ocular paresis is a usual diagnosis in neuro-ophthalmologic consultation, and its aetiology is indeed a challenge. The authors studied 3400 records concerning this consultation, between 1982 and the third quarter of 1993. During this period 221 cases with ocular paresis were selected. During this retrospective study we point out the following items: the cranial nerve affected; the neuro-ophthalmologic semiology; the aetiology and clinical evolution, according to the age groups. From 221 cases selected, 111 were paresis from the VIth pair (50.2%), 88 from the IIIrd pair (39.8%), 14 multiple paresis (6.4%) and 8 paresis from the IVth pair (3.6%). The most frequent complaint was diplopia (> 90%). As far as the aetiological diagnosis is concerned, this was easier to establish in patients > 50 years of age. In this age group the most usual aetiology was vascular and traumatic pathologies. In younger patients the most frequent pathologies were traumatic and tumoral. The prognostic was better in the vascular group, the paresis recovery being > 50% in all other pathologies, except the tumoral one.
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PMID:[Oculomotor paralysis. The perspective of a neuro-ophthalmology consultation]. 807 1

A 21 year old man with a five month history of facial paresis, diplopia, and gait disturbance diagnosed with a brain stem tumor at another institution was evaluated. Computed tomography, magnetic resonance imaging, clinical and laboratory evaluations suggested a pontine astrocytoma, and the mass was excised. Pathological diagnosis was a tuberculoma confirmed by postoperative positive Mantoux testing. CT and MRI appearances of tuberculomas have been described, but can not differentiate them completely from other tumors such as astrocytomas. Because the incidence of tuberculomas has increased in recent years and they may mimic exophytic tumors of pons, it is important to include pontine tuberculoma in the differential diagnosis of pontine tumors.
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PMID:A pontine tuberculoma mimicking an exophytic brain stem tumor. 812 91

We report a 62-year-old man with a pelvic mass, who developed multiple cranial nerve palsies on the right side. He was well until the summer of 1977 when he developed a numb sensation in the sacral region. In the next year, a huge tumor was found in the sacral area in another hospital. Most of the tumor was resected at that time. Post-operative course was uneventful. In July 1988, there was an onset of weakness in his legs, gait disturbance, and dysuria. Myelography at the above hospital revealed a complete block at the seventh thoracic level. He was treated by laminectomy and post-operative radiation. In June 1990, he developed a neuralgic pan in his right leg. Two months later, he noted diplopia, deafness in his right ear, and swallowing difficulty. He was admitted to our hospital for further work up on January 14th of 1991. On admission, he was afebrile. General physical examination revealed a 4 cm had mass in his right anterior chest attaching the rib. Gynecomastia was noted bilaterally. Liver was felt by 5 cms under the right hypochondrium. The edge of the liver was firm. On neurologic examination he was an alert and mentally sound man. His higher cerebral functions were intact. In the cranial nerves, complete palsy of the abducens nerve, mild nerve deafness, paresis of the soft palate, atrophy and weakness of the sternocleidomastoid and upper trapezium muscles, all on the right side, deviation of the tongue to the right, slurred speech, and dysphagia were observed. The neck was supple. He was able to walk with a support. Mild weakness was present in his right lower extremity. Both legs were spastic. No ataxia or involuntary movements were noted. Deep reflexes were symmetric and normally active. No sensory loss was observed. No meningeal signs were present. Pertinent laboratory findings included moderate anemia (Hb 8.8 g/dl), LDH 2,631 U/l, CRP 7.4 mg/dl. The CSF was under an increased pressure (OP 260 mmH2O) containing 2 lymphocytes/ml, 43 mg/dl of protein, and 49 mg/dl of glucose. Radiologic examinations revealed a destructive change in the sacrum, lytic lesions in the seventh thoracic spine and in the clivus.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A 62-year-old man with multiple cranial nerve palsies on the right side and a pelvic mass]. 821 5

A 74-year-old woman, with hypertension and dilated cardiomyopathy, presented with sudden onset of diplopia without vertigo and other neurological symptom. Examination revealed left inferior rectus muscle paresis. Other neurological findings were normal. She had no cerebellar ataxia and sensori-motor dysfunction. Magnetic resonance imaging showed increased signal intensity on T2-weighted and proton density-weighted images in the right ventral midbrain, compatible with infarction involving the fascicular oculomotor fibers. Complete resolution of the diplopia and normal ocular motility were noted 3 months after the onset of the diplopia. Focal ischemic midbrain lesions should be considered in cases of isolated partial oculomotor nerve paresis.
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PMID:[Isolated inferior rectus muscle paresis from midbrain infarction]. 837 Feb 6


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