Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 61-year-old man suddenly heard tinnitus and diplopia at night during watchinng television. A few days later he visited at our hospital. Neurologically he exibited marked isolated right superior rectus palsy which was also indicated by the Hess test. No other neurological abnormalities were found such as other ocular muscle paresis, cranial nerve palsies, hemiparesis, sensory impairement or cerebellar ataxia. MRI showed a left medial thalamic infarction extending to a rostral part of the midbrain anterolateral to the cerebral aqueduct at the superior colliculi level. Unilateral superior rectus palsy can rarely be caused by a contralateral midbrain infarction, because fibers from the subnucleus subserving the superior rectus decussate within the oculomoter nerve complex. In this case the crossing fibers toward the contralateral superior rectus may have been selectively involved by a tinny lesion in the area of the oculomotor nucleus. The patient had a slightly narrowed right palpebral fissure. It is indicated that crossing fibers toward the contralateral levator muscle of the eyelid may be also involved. The patient's diplopia completely resolved two months later after the onset.
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PMID:[Isolated crossed superior rectus palsy in a midbrain infarction]. 1602 71

Middle-ear ceruminous adenomas are rare benign neoplasms arising from the epithelium of the middle ear. Progressive hearing loss, ear fullness and tinnitus are common symptoms of this tumour; facial nerve paresis and vestibular disturbances occur very infrequently. We present two cases of middle-ear ceruminous adenomas, one showed rapid unilateral hearing loss with aural fullness, followed by purulent aural discharge and vertigo. In the second case, the disease affected an already deaf ear and the only symptom of the disease was increasing vertigo. The clinical features, intraoperative findings, and histological and radiological findings are presented. The cases are compared to those described in the literature.
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PMID:Middle-ear ceruminous adenoma as a rare cause of hearing loss and vertigo: case reports. 1619 81

A 55-year-old male presented with left-sided otorrhoea, hearing loss and tinnitus of 3 months duration. On clinical examination polypoid tissue was seen prolapsing in the external ear canal. A CT scan of the mastoid cells and middle ear showed otomastoiditis with osteolysis. Oral antibiotic therapy and eardrops were started. When a facial nerve paresis appeared one month later, a mastoidectomy was performed. The mastoid cells and middle ear were filled with a connective tissue-like substance. Postoperative corticosteroids were administered. Despite the therapy the facial nerve problem aggravated and the patient developed severe parietotemporal headache, meningeal irritation and somnolence. The diagnosis of neurosarcoidosis was hypothesised. Blood analysis, including c-ANCA's, culture of the otorrhoea and biopsies of the connective tissue were inconclusive. A CT scan of the brain showed thickening of the left tentorium. A biopsy of the dura indicated a diagnosis of Wegener's granulomatosis. The patient was treated with immunosuppressive medication with satisfactory results.
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PMID:Wegener's granulomatosis presenting as otomastoiditis. A case report. 1667 40

A large endolymphatic sac papillary adenocarcinoma in a patient with Von Hippel-Lindau (vHL) disease is reported. A 31-year-old man was treated for a left eye retinal angioma 10 years previously and had been blind in that eye since. He was admitted with progressive tinnitus, lower cranial nerve paresis and ataxia. Investigations revealed a vascular and bone-eroding petrous tumour. The entirely extradural tumour involved a large part of the petrous bone and extended into the cerebellopontine angle. The vascular tumour was radically resected using a presigmoid approach after feeding vessel embolisation. The literature on this rare clinical entity is briefly discussed.
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PMID:Endolymphatic sac carcinoma of the right petrous bone in Von Hippel-Lindau disease. 1667 27

Vertigo and imbalance are believed to be rare manifestations of skull base neoplasms. Patients with skull base neoplasms can present with vague otolaryngological complaints, including diplopia, facial numbness, facial weakness, hearing loss, tinnitus, hoarseness, headache, and otalgia. Physical examination of these patients can sometimes reveal paralysis or paresis of cranial nerves. Magnetic resonance imaging (MRI) is the gold standard for evaluation of cranial nerve involvement in skull base diseases. Vertigo and imbalance can be manifestations of a neuropathy or lesion within the vestibular system and may be subtle or overlooked findings in patients with skull base diseases. The purpose of this article is to review the clinical manifestations of patients presenting with vertigo and imbalance who were found to have skull base neoplasms. We will also highlight the importance of MRI in diagnosis and management of these patients.
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PMID:The importance of magnetic resonance imaging in the evaluation of vertigo and imbalance. 1717 Nov 43

Stapedial surgery is able to obtain excellent hearing results in the long-term in most otosclerotic patients. Nevertheless, some cases have vertigo and/or tinnitus after surgery, that may lead them to revision surgery. Out of a consecutive series on 115 patients, we present three cases (2,6%) with persistent vertigo after stapedotomy. These patients had residual unsteadiness despite good hearing after surgery, with a minimum follow-up of 12 months. Videonystagmography showed spontaneous nystagmus towards the contralateral ear in one case, whereas the other two had a canalicular paresis in the operated side, signs of vestibular hypofunction. After vestibular rehabilitation, unsteadiness resolved in all cases, with good spontaneous compensation, without any further surgery.
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PMID:[Delayed vertigo after stapedotomy with good hearing results]. 1803 Aug 51

Osteomas occur throughout the temporal bone and, depending on their location, may cause tinnitus, hearing loss, vertigo, and facial nerve paresis. We present a rare case of a 25-year-old woman with a mastoid osteoma enlarging over a 6-month period. Other than a cosmetic deformity of her upper neck, the patient was asymptomatic. After surgical removal of the bony neoplasm, the patient was noted to have a high-frequency sensorineural hearing loss. This case study presents clinical, radiologic, intraoperative, pathologic, and audiometric findings of a mastoid osteoma and a review of the literature.
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PMID:Giant mastoid osteoma with postoperative high-frequency sensorineural hearing loss. 1835 40

Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, is a disorder of elevated intracranial pressure of unknown cause. Patients present with daily headache, pulse-synchronous tinnitus, transient visual obscurations, papilledema with its associated visual loss, and diplopia from sixth nerve paresis. Many disease associations have been alleged, but few besides obesity, hypervitaminosis A and related compounds, steroid withdrawal, and female gender have been proven. Although absorption of cerebrospinal fluid (CSF) occurs through arachnoid granulations and extracranial lymphatics, outflow resistance is increased in IIH; therefore, intracranial pressure must increase for CSF to be absorbed. The mainstays of medical treatment are a reduced-sodium weight-reduction program and acetazolamide. If patients fail medical therapy, surgical procedures, most commonly optic nerve sheath fenestration and CSF shunting, are employed. The main morbidity of IIH is visual loss. This is present in most patients and can usually be reversed if recognized early in the course of the disease and treated.
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PMID:Idiopathic intracranial hypertension (pseudotumor cerebri). 1846 Feb 75

Cavernous angiomas are vascular malformations that are seldom found in the cerebellopontine angle or in the internal auditory canal. We report the case of a 51-year-old man suffering from a rapidly progressive hearing loss, tinnitus and minor unsteadiness. Neurootological examination showed a canal paresis of 91% on the right side. The subsequent neuroradiological examination with magnetic resonance imaging revealed a tumour of the cerebellopontine angle with intracanalicular extension. The observed intensities on T1-, T2- and gadolinium-enhanced sequences suggested the diagnosis of a vestibular schwannoma. Intraoperatively, a reddish tumour was found and histological examination revealed a cavernous angioma. Even though extensive diagnostic procedures were performed, the correct diagnosis could not be established preoperatively.
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PMID:Cavernous angioma of the cerebellopontine angle. 1863 29

Since Dandy first reported vascular compression of the trigeminal nerve, the concept of neurovascular compression syndrome for trigeminal neuralgia and hemifacial spasm (HFS) has been accepted, and neurovascular decompression has been performed for this condition. The further investigations indicated that some other clinical syndromes such as glossopharyngeal neuralgia, disabling positional vertigo, tinnitus, geniculate neuarlgia, spasmodic torticolis, essential hypertension, cyclic oculomotor spasm with paresis and superior oblique myokymia also may be initiated by vascular compression of the glossopharyngeal, cochleovestibular, intermediate, accessory, oculomotor and trochlear nerves or the ventrolateral medulla oblongata. In this study several hypotheses regarding the development of cranial nerves vascular compression syndromes are presented. It is alsoemphasized the value of high-resolution magnetic resonance tomographic angiography for visualization of vascular compression. The most frequent clinical syndromes caused by vascular compressionof the cranial nerves are discussed regarding the pathogenesis, symptomes and therapy. We present our series of 124 patients with preoperative evidently positive finding of vascular compression to the trigeminal nerve (MRI). Microvascular decompression (MVD) was performed in all of them. Initial postoperative result was excellent in 110/124 (89%) patients,while in 11/124 (9%) patients the pain relief was satisfactory. In the remaining three patients MVD failed. Recurrence of pain after two years reached 19%. Complications were related to diplopia associated with transient fourth nerve dysfunction in 5 (4%) patients, facial motor dysfunction in 4 (3%) patients, transient facial hypesthesia in 27 (22%) patients and partially hearing loss in 4 (3%) patients. Cerebellar hemorrhagic infarction occurred in 1 (0.8%) patient and cerebrospinal fluid leaks appeared in two (1.6%) cases. There was no lethal outcome.
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PMID:[Neurovascular compression (conflict)]]. 1879 90


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