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

The author discussed the increase in the frequency of traumatic paralyses of the ocular muscles, and reported 6 cases of inferior oblique muscle paresis caused by local blunt or sharp traumas (haematoma, contusion, rupture, incarceration) and one case of traumatic Brownian pseudo-paralysis. The localisation of the injuries in 3 cases was on the inferior temporal part and in the other 3 cases on the superior part of the bulbar conjunctiva. Atypical horizontal deviation and characteristic vertical deviation, torsion and torticollis were observed in the majority of cases. One patient recovered spontaneously. 3 patients became asymptomatic after correction by prisms and one after recession of contralateral superior rectus muscle. The symptoms remained unchanged in the case of a "blow out" fracture (in spite of operation) and a Brown's syndrome (without treatment).
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PMID:[Traumatic palsies of the inferior oblique muscle (author's transl)]. 96 15

We compared surgical results of superior oblique tenotomy to the superior oblique silicone expander for the treatment of superior oblique overaction and Brown syndrome. Of 24 patients with bilateral superior oblique overaction, 13 underwent tenotomy and 11 had the silicone expander procedure. Reduction of A-pattern to within 10 prism diopters was achieved in 12/13 (92.3%) tenotomy patients and in 10/11 (90.9%) patients undergoing silicone expander (P greater than .05). Correction of superior oblique overaction on versions to within +/- 1 dysfunction was achieved in 22/26 (84.6%) of the tenotomies, and 21/22 (95.5%) silicone expander procedures (P greater than .05). Zero superior oblique dysfunction was found after 14/26 (53.8%) tenotomy procedures versus 18/22 (81.8%) silicone expander operations (P = .041). Superior oblique paresis occurred postoperatively in 4/13 (30.8%) tenotomy patients, whereas none of the 11 patients in the silicone expander group had superior oblique paresis (P = .044). Six patients who underwent superior oblique tenotomy for superior oblique overaction had preoperative stereopsis; following surgery, only two maintained the same level of stereopsis, and three patients totally lost all stereo acuity. All patients in the silicone expander group either maintained or had improved stereo acuity postoperatively. Seven patients with true Brown syndrome were operated on: three underwent the silicone expander procedure and four had a superior oblique tenotomy with an ipsilateral inferior oblique recession. The combination of superior oblique tenotomy with simultaneous ipsilateral inferior oblique recession resulted in an undercorrection in two of the four patients, whereas all three patients in the silicone expander group showed excellent ocular motility postoperatively, with two having normal versions and one a -1 residual limitation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of superior oblique tendon expander to superior oblique tenotomy for the management of superior oblique overaction and Brown syndrome. 158 83

The report describes seven SMA-cases in descendents of crossbreeds of American Brown Swiss x Deutsches Braunvieh. Symptoms and course: After initially normal development of the calves for one to six weeks the disease set in suddenly followed by a rapid lethal course of one to one and a half weeks duration due to asphyxia and/or secondary diseases. Only one case was reported having been sick since birth (?). Characteristic signs were rapidly progressing muscular atrophy, paresis and paralysis of the limbs, the trunk and the diaphragm, usually accompanied by progressive dyspnoea. Signs of congenital neuromyodysplasia (arthrogryposis) of different degree were present in four of the seven calves. Six calves had contracted a secondary pneumonia. Blood gas analysis (6/7) revealed a compensated (1x) or decompensated (4x) respiratory acidosis. Neurohistological findings: Degeneration and loss of motor neurons in the ventral horns of the spinal cord and neurogenic muscular atrophy. Immunohistochemistry revealed a pronounced accumulation of type 200 kD-neurofilaments in perikarya and dendrites of ventral horn motoneurons indicating disturbed mechanisms of the axonal transport. The disease seems to be inherited as a recessive trait.
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PMID:[Spinal muscle atrophy in Brown Swiss x Braunvieh cross calves]. 163 59

The authors report 12 cases of isolated inferior oblique muscle paresis which is very uncommon and mostly of congenital origin, though trauma is also cause. The clinical features, differential diagnosis and treatment of the disease are discussed. Inferior oblique palsy is differentiated from contralateral inferior rectus palsy by Park's 3-step test, and from Brown's syndrome by forced duction test and the overaction of the antagonist superior oblique during version. Surgical procedures include shortening and advancement of the inferior oblique muscle, recession of the contralateral superior rectus and shortening of the contralateral inferior rectus muscle, and tenotomy of the ipsilateral superior oblique.
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PMID:[Diagnosis and treatment of inferior oblique muscle paresis]. 239 Sep 1

Direct trauma to the superior-oblique muscle of the eyeball may result in active and passive ocular motility disturbance, e.g. paresis, Brown phenomenon, cyclorotation disorder, head-tilt and faulty head posture. In individual cases combinations of these and rather complex forms may occur. Surgery should aim at sufficient centralization of the binocular field of vision. The author usually recommends indirect procedures, at the ipsilateral inferior oblique muscle, to correct excyclorotation, or at the contralateral inferior rectus muscle to correct paresis. A pronounced Brown phenomenon should be treated by recession of the superior oblique muscle, or rather its transposition to the nasal side of the superior rectus. In addition, recession of the contralateral superior-rectus muscle or resection of the ipsilateral inferior-rectus muscle may be advisable. Out of eight patients, one refused surgery, five were sufficiently cured in one session, and another patient in three surgical sessions. One patient could not be satisfactority treated by surgery; in addition to a Brown phenomenon she had excyclorotation, especially in down-gaze, and paresis of the superior oblique muscle plus severe neuralgic pain in up-gaze. In this patient the trochlea had been accidentally lost during a foreign-body excision in the upper medial orbit. A secondary reconstruction of the trochlea was found not to be advisable in this patient, because the neuralgia was thought to be due to traction within the superior oblique tendon or the periost.
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PMID:[Direct superior oblique muscle trauma and dysfunction--surgical possibilities and results]. 258 46

Fifteen patients with bilateral trochlear paresis underwent oblique muscle surgery. In 12 cases, a superior oblique tuck and inferior oblique recession were performed uni- or bilaterally. In 3 cases, a superior oblique muscle tuck was sufficient. Excyclotropia and vertical deviations in adduction, primary position and abduction were alleviated by surgery in most cases. The upper and lower limits of the field of single binocular vision were on average 15 degrees in the upward-gaze and 25 degrees in the downward-gaze. The presence of postoperative Brown syndrome was rarely disturbing to the patient. Postoperatively, the effects of surgery decreased only slightly over time. We found that in cases of bilateral superior oblique palsy, a tuck in one or both superior oblique muscles sufficed only when the excyclotropia in the primary position did not exceed 15 degrees, when the vertical deviation in adduction did not exceed 3 degrees and when the V-pattern was minimal. We found that uni- or bilateral surgery on both superior and inferior oblique muscles could successfully alleviate excyclotropia of more than 20 degrees with a vertical deviation in the primary position of more than 5 degrees.
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PMID:[Combined oblique muscle surgery in bilateral trochlear paralysis]. 262 5

Surgical management of overaction of the superior oblique muscle is discussed with reference to such conditions as A-pattern, Brown's syndrome, torsional torticollis, and homolateral inferior oblique or contralateral inferior rectus paresis. The authors perform weakening of the superior oblique from the temporal side of the superior rectus for slight or moderate overaction. They prefer posterior tenectomy for mild overaction and scleral disinsertion of the tendon in moderate overaction causing A-pattern of no more than 25 pd. With 25-30 pd. they perform translation-recession of the muscle by the nasal approach.
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PMID:Management of superior oblique overaction in A-pattern deviations. 328 95

Nine feedlot cattle showed clinical signs consistent with those expected in thromboembolic meningoencephalitis. These signs included pyrexia, ataxia, posterior paresis, paralysis and coma. Brown necrotic foci with haemorrhagic borders were observed in the brains of three animals that had died. In these foci vasculitis, thrombosis, infarction and neutrophil infiltration were observed during microscopical examination. Haemophilus somnus was isolated in pure culture from the brains.
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PMID:Thromboembolic meningoencephalitis diagnosed in Natal. 402 Aug 20

Chronic inflammatory sinus disease is a common process, sometimes requiring nasal and paranasal sinus surgery. Extraocular muscle dysfunction is a rare surgical complication of sinus surgery, but has been reported. Previous studies have been concerned with trauma to the medial rectus muscle resulting in severe paralysis or restriction. This study reports five patients with acquired strabismus and symptomatic vertical diplopia secondary to sinus surgery. In all patients, the resultant diplopia was disabling. Four patients had frontal sinus window surgery performed, with incisions placed in the supero-nasal quadrant of the orbit, below the eyebrow (a modified Lynch incision). Three patients acquired a superior oblique paresis and the fourth developed a Brown's syndrome. The location of the skin incision was critical to injury in the trochlear area. The fifth patient underwent a nasal polypectomy and antrostomy with secondary orbital hemorrhage and proptosis. A mild inferior rectus paresis was the result.
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PMID:Superior oblique and inferior rectus muscle injury following frontal and intranasal sinus surgery. 404 49

Either muscle weakness (paresis) or mechanical restrictions can account for diminished ocular rotation. In practice, restrictions are more commonly seen. The forced duction test, differential intraocular pressure measurement and saccadic velocity studies can all assist in documenting the presence of restriction. Restrictions frequently occur with orbital floor fracture, endocrine ophthalmopathy and Brown's syndrome, and following multiple stabismus procedures, orbital or retinal detachment surgery, or muscle transposition surgery. They also occur as a result of antagonist muscle contracture after rectus muscle palsy or they may be due to orbital tumor or inflammation.
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PMID:Restrictive factors in strabismus. 635 14


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