Botox® after Botox® - a new approach to treat diplopia secondary to cosmetic botulinic toxin use: case reports / Botox® após Botox® - uma nova abordagem para tratamento de diplopia secundária ao uso cosmético de toxina botulínica: relatos de casos

A new technique for the treatment of diplopia secondary to cosmetic botulinum toxin A use is described. In this interventional case reports, two consecutive patients who developed diplopia after periocular cosmetic use of botulinum toxin A were treated with intramuscular botulinum toxin A injection into the antagonist extraocular muscle. Diplopia resolved in both patients in less than 1 week with no side effects or complications. In conclusion, the injection of intramuscular botulinum toxin A is an encouraging option for treatment of diplopia secondary to botulinum toxin A use for facial lifting.

Uma nova técnica para tratamento de diplopia secundária ao uso estético da toxina botulínica A é descrito. Nestes relatos de casos, dois pacientes consecutivos que desenvolveram diplopia após uso cosmético de toxina botulínica A periocular foram tratados com injeção de toxina botulínica A no músculo extraocular antagonista. A diplopia melhorou em menos de uma semana nos dois pacientes, sem efeitos colaterais. Consideramos o uso de injeção intramuscular de toxina botulínica A como uma possível opção para o tratamento da diplopia secundária ao uso da toxina botulínica A para rejuvenescimento facial.

Botulinum toxin in the management of acquired motor fusion deficiency.

Acquired disruption of motor fusion is a rare condition characterized by intractable diplopia. Management of these patients is extremely difficult. Prisms in any combination or even surgery may not help relieve their symptoms. We describe a longstanding case of acquired motor fusion disruption which was managed successfully with botulinum toxin injection.

Neurobrucellosis: report of a case with CVA manifestation

Although neurological symptoms in brucellosis are frequent, central nervous system [CNS] involvement is uncommon. A 42-year-old man was admitted with an episode of faint without loss of consciousness, right hemi paresis, diplopia and headache lasting for four days. The neurological examination revealed left hemi paresis. Limitation of gazing in left eye in lateral view was seen [partial paresis of 6[th] cranial nerve]. The results of laboratory examinations show positive Wright and Coombs Wright in blood and C.S.F. In the brain CT scan hydrocephaly and in magnetic resonance imaging [MRI] some brain atrophy, few high signal foci in the deep with mater had been detected. Treatment included concurrent administration of three drugs: doxycycline, rifampicin and co-trimoxazole. This patient fully recovered. We suggest that Neurobrucellosis [NB] should always be sought in young patients with ischemic stroke, especially if they do not have any additional risk factors for stroke and live in an endemic area for brucellosis, even if they do not have other systemic signs of brucellosis

Anticholinesterase Therapy for Patients with Ophthalmoplegia Following Snake Bites: Report of Two Cases

Although ophthalmoplegia following snake bites is not indicative of a serious neurotoxic complication, symptoms of diplopia, dizziness and ocular discomfort can be emotionally devastating for patients. The authors experienced two cases of ophthalmoplegia following snake bites in Korea. The patients complained of diplopia that had developed several hours after the snake bites. The diplopia did not improve with antivenom treatment, but resolved completely after several injections of neostigmine.