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1.
Article in English | WPRIM | ID: wpr-880602

ABSTRACT

OBJECTIVES@#Oculomotor nerve palsy is a kind of disease with many causes, showing eye movement disorders, abnormal eyelid position, and/or damage of the pupil. The etiology of oculomotor nerve palsy in different departments is different. The study discussed the etiology, localization of the lesion, and prognosis for oculomotor nerve palsy firstly diagnosed in department of ophthalmology.@*METHODS@#Clinical data of 137 hospitalized patients with oculomotor nerve palsy at the Department of Ophthalmology, the First Medical Center of PLA General Hospital from 2009 to 2018 were retrospectively collected. The etiology and its distribution characteristics in different age groups, the location of the lesion, and the prognosis of patients were analyzed.@*RESULTS@#In 137 patients, the top 3 causes for oculomotor nerve palsy were head trauma (38.69%), cavernous sinus lesions (12.40%), and orbital inflammation (9.49%). Other causes included intracranial aneurysm, the intracranial space-occupying lesion, cerebral vessel diseases, infection, orbital tumors, diabetes, the operation of nasal cavity. Traumatic oculomotor nerve palsy was more common in young adults aged 20-49 years and in the patients with cerebral vascular disease in elderly people aged 60-69 years, while diabetic oculomotor nerve palsy is common in middle-aged and elderly people aged 50-69 years. The age distribution of other etiological types was relatively balanced. Seventy-five cases of orbital apex lesions were due to trauma, inflammation, infection, and tumor; 40 cases of cavernous sinus lesions were due to inflammation, tumor, and thrombosis; 6 cases of subarachnoid lesions were due to aneurysms, tumors, and trauma; 5 cases were oculomotor nucleus lesions were due to infarction; 11 cases could not be allocated because of unknown etiology. After treatment, the corrected visual acuity of oculomotor nerve palsy side was not significantly improved. The patients with oculomotor nerve palsy caused by intracranial aneurysm, cerebrovascular disease, and diabetes mellitus had the highest proportion of partial or complete recovery from ptosis and ocular dyskinesia.@*CONCLUSIONS@#Oculomotor nerve palsy is a common cause of ophthalmoplegia and diplopia. Head trauma, cavernous sinus lesions, and orbital inflammation are the most common causes for oculomotor nerve palsy first diagnosed in ophthalmology department. Traumatic oculomotor nerve palsy is common in adolescents. Oculomotor nerve palsy caused by diabetes and cerebrovascular disease are common in the middle-aged and elderly people. Most of the lesions locate in the orbital apex and cavernous sinus. The prognosis of corrected visual acuity is poor. The prognosis of ptosis and ocular dyskinesia caused by intracranial aneurysm, cerebrovascular disease, and diabetes is good. Figuring out the cause timely and accurately is the basis and key to treat oculomotor nerve palsy.


Subject(s)
Adolescent , Adult , Aged , Cavernous Sinus , Humans , Middle Aged , Oculomotor Nerve Diseases/etiology , Ophthalmoplegia , Prognosis , Retrospective Studies , Young Adult
2.
Rev. méd. Chile ; 146(11): 1356-1360, nov. 2018. graf
Article in Spanish | LILACS | ID: biblio-985711

ABSTRACT

Giant cell arteritis is the most common vasculitis in patients aged over 50 years. We report an 89-year-old woman with significant weight loss and persistent frontal-occipital headaches lasting two months. The neurological examination at admission identified a decrease in visual acuity of the left eye, paralysis of the third cranial nerve of the right eye and alterations of body motility without objective signs of damage of the motor or sensitive pathways. Magnetic resonance imaging showed changes of the temporal artery wall and in both vertebral arteries, as well as bilateral cerebellar and occipital ischemic lesions. The Doppler ultrasound of the temporal arteries was compatible with Giant cell arteritis. Treatment with steroids was started. While receiving oral prednisone, the patient suffered new infarcts of the posterior territory, documented with a CAT scan.


Subject(s)
Humans , Female , Aged, 80 and over , Giant Cell Arteritis/diagnostic imaging , Basilar Artery/diagnostic imaging , Vertebral Artery/diagnostic imaging , Oculomotor Nerve Diseases/diagnostic imaging , Brain Ischemia/diagnostic imaging , Oculomotor Nerve/diagnostic imaging , Temporal Arteries/diagnostic imaging , Giant Cell Arteritis/etiology , Giant Cell Arteritis/pathology , Basilar Artery/pathology , Vertebral Artery/pathology , Magnetic Resonance Imaging/methods , Oculomotor Nerve Diseases/etiology , Oculomotor Nerve Diseases/pathology , Brain Ischemia/etiology , Brain Ischemia/pathology , Ultrasonography, Doppler/methods , Oculomotor Nerve/pathology
3.
Rev. chil. endocrinol. diabetes ; 8(3): 108-111, jul. 2015. ilus
Article in Spanish | LILACS | ID: lil-789373

ABSTRACT

Silent corticotroph adenomas (SCA) are pituitary adenomas inmunoreactive to ACTH without hormonal overproduction and they form the 3 percent of the pituitary adenomas. Unlike the ademonas that cause the Cushing’s disease, frequently the SCA are aggressive macroademonas and their clinical expressions are the compromise of nearby structures with or without pituitary apoplexy. Frequently, the treatment chosen is a surgical procedure, albeit the total resection difficulties. The SCA are not diagnosed until an anatomopathological and immunohistochemical study is carried out. In this document, a case study of a woman diagnosed with a clinically silent macrocorticotroph adenomadiscovered by a third nerve palsy is explained.


Subject(s)
Humans , Female , Middle Aged , ACTH-Secreting Pituitary Adenoma/diagnosis , ACTH-Secreting Pituitary Adenoma/therapy , Oculomotor Nerve Diseases/etiology , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/therapy , Adenoma/diagnosis , Adenoma/therapy , Paresis
4.
Rev. cuba. pediatr ; 85(2): 252-257, abr.-jun. 2013.
Article in Spanish | LILACS | ID: lil-678137

ABSTRACT

La parálisis aislada del tercer par craneal no es frecuente en los niños. Entre las causas que la originan se encuentran las congénitas, traumáticas, infecciosas, tumorales, vasculares, tóxicas y desmielinizantes. Se presenta un paciente de 3 años de edad con el diagnóstico de una oftalmoplejía aguda dolorosa del tercer par craneal, cuya etiología no se pudo demostrar. El cuadro clínico desapareció de forma espontánea y no ha presentado recurrencias después de 3 años de seguimiento. Se concluye que ante un paciente con parálisis del tercer par craneal es necesario realizar una exhaustiva evaluación con el propósito de precisar las diversas causas que la provocan


Isolated third cranial nerve palsy is not frequent in children. Among the causes are congenital, traumatic, infectious, tumoral, vascular, toxic and demyelinizing. This is the case of a 3-years old patient diagnosed with acute painful ophthalmoplegia of the third cranial nerve, in which etiology could not be proved. The clinical picture disappeared spontaneously and no recurrence has emerged after 3 years of follow-up. It was concluded that when dealing with a patient with third cranial nerve palsy, it is necessary to make a thorough assessment to precise over the different causes


Subject(s)
Humans , Male , Oculomotor Nerve Diseases/diagnosis , Oculomotor Nerve Diseases/etiology , Ophthalmoplegia/diagnosis
7.
Arq. neuropsiquiatr ; 65(1): 176-178, mar. 2007. ilus
Article in English | LILACS | ID: lil-446706

ABSTRACT

The article describes a woman with 53 year-old that has presented diplopia when looking down and adopted a tilted head position in order to read for the last six months. The neuro-ophthalmic examination shows isolated right superior oblique muscle paresis. The magnetic resonance and the angioresonance show the dolicoectatic basilar artery compressing the right ventral lateral brainstem.


O artigo descreve uma mulher de 53 anos que há seis meses apresenta diplopia ao olhar para baixo, além de adotar postura inclinada da cabeça para ler. O exame neuro-oftalmológico revelou paresia isolada do músculo oblíquo superior direito. Os exames de ressonância magnética e angioressonância evidenciaram dolicoectasia da artéria basilar, que comprimia a face ventral lateral direita do tronco cerebral.


Subject(s)
Female , Humans , Middle Aged , Oculomotor Nerve Diseases/diagnosis , Vertebrobasilar Insufficiency/diagnosis , Constriction, Pathologic/etiology , Dilatation, Pathologic/complications , Diplopia/diagnosis , Diplopia/etiology , Magnetic Resonance Angiography , Oculomotor Nerve Diseases/etiology , Tomography, X-Ray Computed , Vertebrobasilar Insufficiency/complications
8.
Indian J Ophthalmol ; 2007 Jan-Feb; 55(1): 79; author reply 79
Article in English | IMSEAR | ID: sea-70626
9.
Article in English | WPRIM | ID: wpr-152550

ABSTRACT

A rare case of bilateral third cranial nerve palsy due to a ruptured anterior communicating artery aneurysm is presented. A 68-yr-old woman was semicomatose with bilaterally fixed dilated pupil, abducted eyes, and ptosis. A computed tomography demonstrated extensive hemorrhage spreading around the both Sylvian and interhemisheric fissure without focal mass effect. Intracranial pressure via extraventricular drainage before surgery was 15-50 mmHg. Three months later, brain MRI showed infarction of left posterior cerebral artery territory and lacuna infarction of the pons. Eleven months after aneurysm repair, nerve palsy improved slowly and recovered partially. The patient communicated well with simple words. The author reviewed and discussed the possible mechanism of this rare neuro-ophthalmological manifestation in view of a false localizing sign.


Subject(s)
Rupture, Spontaneous , Oculomotor Nerve Diseases/etiology , Magnetic Resonance Imaging , Intracranial Aneurysm/complications , Humans , Female , Aged
10.
Article in English | IMSEAR | ID: sea-39251

ABSTRACT

To study the clinical characteristics, treatment and outcome of patients with aneurysmal third nerve palsy. Eleven patients with isolated third nerve palsy from an intracranial aneurysm from 1998 to 2002 at Ramathibodi Hospital were reviewed retrospectively. The average age was 60 years. Ipsilateral headache and/or retroorbital pain occured in 80 percent of the patients. Ten patients had unilateral disease, whereas one patient had bilateral involvement. The most common site of aneurysm was at the origin of the posterior communicating artery. Endovascular treatment with coil embolization provided successful occlusion as well as neurosurgical clipping. Recovery of third nerve function was found in all patients but had variable degrees. Patients who received early treatment, especially within 10 days after onset of oculomotor dysfunction appeared to have the best chance of recovery. Aberrant regeneration developed in 5 cases. The commonest sign was lid retraction during adduction and downward gaze.


Subject(s)
Adult , Aged , Female , Humans , Intracranial Aneurysm/complications , Male , Middle Aged , Oculomotor Nerve Diseases/etiology , Recovery of Function , Retrospective Studies , Thailand , Treatment Outcome
11.
Neurol India ; 2003 Sep; 51(3): 388-9
Article in English | IMSEAR | ID: sea-121310

ABSTRACT

This is a case report of a lady who presented with pupil-sparing Weber's syndrome. She had left oculomotor nerve palsy with normal pupil and right hemiparesis. The patient subsequently made a good recovery. An ischemic lesion of the lower mid-brain was demonstrated on the MRI scan of the brain, which corresponds to the motor nucleus of the oculomotor nerve. The article also describes the neuroanatomy of the oculomotor nerve and how its partial lesions lead to sparing of the pupil. In addition, this case report documents that a pupil-sparing Weber's syndrome could be reversible.


Subject(s)
Aged , Brain Stem Infarctions/complications , Female , Humans , Magnetic Resonance Imaging , Oculomotor Nerve Diseases/etiology , Reflex, Pupillary
12.
Neurol India ; 2003 Mar; 51(1): 75-6
Article in English | IMSEAR | ID: sea-121598

ABSTRACT

A 21-year-old male presented with sudden onset of right-sided third nerve paresis. Angiogram showed a fenestrated posterior communication artery on the right side and no other vascular anomalies. There was no other lesion that could suggest a cause for the third nerve weakness. Fenestration of the posterior communicating artery has not been reported till date. The case is discussed and the literature on the subject is reviewed.


Subject(s)
Adult , Cerebral Angiography , Humans , Male , Oculomotor Nerve Diseases/etiology , Paresis/etiology , Posterior Cerebral Artery/abnormalities
13.
Arq. bras. oftalmol ; 63(1): 87-9, jan.-fev. 2000. ilus
Article in Portuguese | LILACS | ID: lil-289983

ABSTRACT

Devido á raridade do fato, o autor apresenta 2 casos de paralisia de IV nervo, secundários de III e VI nervos geralmente evoluíram para a descompensaçäo com hiperaçäo secundária de oblíquo inferior, o que levou á cirurgia, com excelentes resultados.


Subject(s)
Humans , Male , Adolescent , Adult , Diabetes Mellitus/complications , Diabetes Mellitus/rehabilitation , Oculomotor Nerve Diseases/surgery , Oculomotor Nerve Diseases/etiology , Trochlear Nerve
14.
Article in English | IMSEAR | ID: sea-43143

ABSTRACT

A 52-year-old man presented with unilateral headache for 6 days. Physical examination revealed an ipsilateral paresis of the superior division of the oculomotor nerve with chemosis. CT scan of the paranasal sinuses showed ipsilateral sphenoid sinusitis with cavernous sinus involvement. The symptoms were completely improved by medical treatment only.


Subject(s)
Acute Disease , Humans , Male , Middle Aged , Nerve Compression Syndromes/etiology , Oculomotor Nerve Diseases/etiology , Sphenoid Sinusitis/complications
15.
Rev. bras. oftalmol ; 52(4): 19-25, ago. 1993. tab
Article in Portuguese | LILACS | ID: lil-276035

ABSTRACT

Os autores apresentam para registro uma série que engloba 814 pacientes com paresias adquiridas dos III, IV e VI nervos cranianos correspondente a um período de estudo de trinta anos (1961-1990). Uma análise da incidência, etiologia, seguimento e posterior recuperaçäo é aqui realizada. Fatores de caráter sócio-econômico, geográfico e de co-operaçäo por parte dos pacientes acarretam maior dificuldade na realizaçäo de estudos como este, sobretudo em países em desenvolvimento como o nosso. Apesar destas dificuldades encontradas, muitos aspectos de semelhança säo observados nos resultados por nós obtidos e aqueles descritos por Rucker, e Rush e Younge, em seus trabalhos clássicos.


Subject(s)
Humans , Female , Male , Abducens Nerve Diseases/etiology , Oculomotor Nerve Diseases/etiology , Trochlear Nerve Diseases/etiology , Paralysis/etiology , Paresis/etiology , Prospective Studies , Retrospective Studies
17.
Article in English | IMSEAR | ID: sea-39606

ABSTRACT

A case of cryptococcal meningitis with unilateral paresis of the superior division of the oculomotor nerve was reported. The ocular signs were completely improved by antifungal therapy. This case demonstrates that divisional oculomotor paresis occurred in the subarachnoid portion of the third cranial nerve before its anatomic bifurcation.


Subject(s)
Adolescent , Antifungal Agents/therapeutic use , Blepharoptosis/etiology , Eye Infections, Fungal/drug therapy , Female , Humans , Itraconazole , Ketoconazole/analogs & derivatives , Meningitis, Cryptococcal/complications , Oculomotor Nerve Diseases/etiology , Visual Acuity
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