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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 68-year-old man was admitted to the hospital complaining of aphasia and right hemiparesis. Neurological examination revealed aphasia, right hemiparesis and ataxia in the left upper extremity. He showed striking ocular symptoms: intense retraction of the right eyelid (Collier's sign), complete ptosis of the left eyelid which might conceal Collier's sign, marked upward gaze palsy and slight downward gaze palsy. Vertebral angiography and MRI revealed an infarction in the left medial area and the left crus cerebri in the upper midbrain, the left subthalamic area inferomedially extending from the adjacent area to the posterior commissure and the medial area in the left thalamus resulting from occlusion of the left mesencephalic artery. From these MRI findings and the reports on pathological findings of patients with Collier's sign, we suggest that damage in the posterior commissure or its adjacent area may be responsible for the sign. Upward gaze palsy is often associated with Collier's sign because fibers mediating upward gaze may decussate in the posterior commissure. Third nerve palsy is also associated with the Collier's sign in some patients. The mechanism creating Collier's sign may be a disturbance of inhibitory fibers leading to the motoneuron pool of the levator muscle in the posterior commissure or its adjacent area.
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PMID:[A case of midbrain and thalamic infarction showing Collier's sign in one side and blepharoptosis in the other side]. 193 79

A case of a nuclear syndrome of the oculomotor nerve due to trauma is reported. There was 3rd nerve palsy on the ipsilateral side, a superior rectus muscle palsy on the contralateral side and a bilateral ptosis. The location was confirmed by magnetic resonance imaging and CT.
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PMID:[Nuclear syndrome of the common oculomotor nerve after skull injury]. 229 Oct 39

Five patients with isolated ptosis and a paresis of ocular elevation in abduction consistent with an isolated superior division III nerve palsy are reported. In all instances the III nerve appeared to be involved before its reported anatomic bifurcation into a superior and an inferior division, in the anterior cavernous sinus.
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PMID:Superior division paresis of the oculomotor nerve. 403 73

This paper deals with the histopathology of the levator muscle of the upper eyelid obtained in three cases of ptosis due to 3rd nerve palsy. Light- and electron-microscopy show muscle fibers decreased in number and altered, showing vacuolation, mitochondrial degeneration, large glycogen amounts, disorientation of myofibrils and Z-line changes. The findings are discussed and compared to the data reported by others.
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PMID:Ultrastructure of the levator muscle of the eyelid in ptosis due to third nerve palsy. 651 78

A prospective, double masked, randomised study was performed to compare the speed of onset of peribulbar anaesthesia using pH adjusted 0.75% bupivacaine, with and without the addition of hyaluronidase. No significant difference in speed of onset occurred due to the addition of hyaluronidase. There were 7 cases of post operative ptosis in the study group, including 1 case of orbital apex syndrome and 2 cases of transient 3rd nerve palsy. This incidence of post operative ptosis using pH adjusted 0.75% bupivacaine was statistically significantly greater than in a matched control group who received a 50:50 mixture of 1% lignocaine and 0.5% bupivacaine with hyaluronidase (p < 0.05). The possible causes of this increased incidence of post operative ptosis are discussed.
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PMID:The efficacy of 0.75% bupivacaine with pH adjustment and hyaluronidase for peribulbar blockade: the incidence of prolonged ptosis. 801 17

A 10-month-old boy was admitted with ptosis on the left eyelid, which rapidly occurred following a disease with rash about 20 days before admission to our hospital. By history, none of the vaccinations had been performed. On physical examination, his vital signs were stable, and he had marasmus. Isolated left oculomotor nerve palsy was diagnosed. Cranial magnetic resonance imaging was normal. Serum IgM antibody to measles virus was positive. Oculomotor nerve palsy markedly improved on the 15th day of follow-up, and complete improvement was noted on the second month of follow-up. To our knowledge, this is the first case of oculomotor nerve palsy following measles.
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PMID:Isolated left oculomotor nerve palsy following measles. 1254 38

A 64-year-old woman presented with a 2 week history of ptosis and medial-gaze paralysis of her left eye. Computed tomography scanning of the paranasal sinuses revealed an expansile, homogeneous lesion with no contrast enhancement in the sphenoid sinus. The mass was hyperintense on all MR sequences and there was extension of the mass to the left cavernous sinus and optic canal. Operation revealed a large mucocele. Third nerve palsy disappeared 4 weeks after operation. Because the spread of mucoceles is variable, they may cause different symptoms. Radiological evaluation, especially computed tomography and magnetic resonance imaging, are useful in diagnosis of mucoceles and help to explain the clinical symptoms by showing the spread of the lesion.
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PMID:Sphenoid sinus mucocele causing third nerve paralysis: CT and MR findings. 1558 14

Bilateral third nerve palsy often points to the involvement of its nucleus. Third nerve palsy as a result of posttraumatic nuclear involvement is an extremely rare condition. A 23-year-old man presented with a depressed skull fracture after acute head trauma and had Glasgow Coma Scale Score of 9. The diameters of the pupils were 6.5 and 7.5 mm and they were not reactive to light stimulation. There was bilateral ptosis. Computed tomography (CT) relieved bilateral perimesensephalic pneumocephalus. We suggested that bilateral oculomotor nerve paresis might develop in association with posttraumatic bilateral perimesensephalic pneumocephalus, which affected the nucleus of the third nerve.
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PMID:Posttraumatic pneumocephalus-induced bilateral oculomotor nerve palsy. 1631 Nov 55

Traumatic isolated oculomotor nerve palsy is not common. Oculomotor nerve palsy without internal ophthalmoplegia (pupil sparing) is extremely rare. We report a case of this condition in a child. An 11-year-old boy was transferred to our hospital after a head injury in a traffic accident. Neuro-ophthalmic examination showed that the left eye had limited adduction, supraduction, and infraduction, incomplete convergence and left ptosis, but no internal ophthalmoplegia. Magnetic resonance imaging indicated mild bending of the ipsilateral oculomotor nerve at the posterior petroclinoid ligament. One month after injury, movement of the patient's eyes was normal on examination, but there was mild diplopia. The suggested mechanism of the oculomotor nerve palsy with pupil sparing in this case is stretching of the oculomotor nerve at the posterior petroclinoid ligament, maintaining an intact pupillomotor nerve.
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PMID:Traumatic oculomotor nerve palsy. 1697 66

Oculomotor nerve palsy is a relatively rare symptom in pituitary adenoma compared to visual compromise or endocrine deficiency. The causes and recovery remain unclear. A total of 23 patients with pituitary adenomas presenting with oculomotor nerve palsy were reviewed. Patients were treated immediately with glucocorticoid therapy. Elective pure-endoscopic transsphenoidal surgery was used for decompression and histopathological confirmation. The clinical differences of patients with apoplectic (hemorrhage or infarction) (20 patients) and non-apoplectic tumors (three patients) were compared. In the apoplectic group, hemorrhage was noted in 13 patients and infarction in seven. Most patients presented with ptosis, followed by limited gaze and diplopia. In the long-term follow-up, the overall complete recovery rate was 19/23 (82.6%): 18/20 in the apoplectic group (90%), and one in three patients in the non-apoplectic group (33%). The median recovery time was 9 days after surgical decompression; and early treatment resulted in early recovery (p = 0.03). Patients with pupil-sparing pituitary adenoma recovered more rapidly than those with pupil involvement (p = 0.012). Patients with minor symptoms recovered earlier than patients with complete palsy (p = 0.003). MRI revealed that the tumor had invaded the interclinoid ligament region in all patients. We conclude that oculomotor nerve palsy usually occurs in patients with apoplectic adenomas, especially those with hemorrhage. Early treatment, pupil-sparing, and minor oculomotor symptoms are factors indicating a good recovery. Endoscopic transsphenoidal surgical decompression achieved good results in this study.
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PMID:Surgical outcome of oculomotor nerve palsy in pituitary adenoma. 2192 Jul 56


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