ABSTRACT
A 43-year-old man with Behçet's disease developed a left oculomotor palsy and a right elevation paresis. His clinical picture was consistent with an isolated fascicular third cranial nerve palsy, considering the mass effect of a large left capsulothalamic lesion extending down into the mesencephalon, which was visualized by CT and (more precisely) by MRI. The patient's clinical status was improved with steroid and immunosuppressive therapy, and radiologic abnormalities resolved markedly in a month.
Subject(s)
Behcet Syndrome/complications , Adult , Behcet Syndrome/diagnosis , Humans , Magnetic Resonance Imaging , Male , Mesencephalon/pathology , Oculomotor Nerve Diseases/complications , Oculomotor Nerve Diseases/diagnosis , Thalamus/pathology , Tomography, X-Ray ComputedABSTRACT
We report the case of a patient with hyperkalemic periodic paralysis and lid lag. The myotonic origin of this rare finding is discussed.
Subject(s)
Eyelid Diseases/complications , Hyperkalemia/complications , Paralysis/complications , Periodicity , Adult , Humans , Male , Muscular Diseases/complicationsABSTRACT
The authors developed an automated method of pupil perimetry by linking an infrared video pupillometer to a Humphrey Field Analyzer. Software was developed to automatically analyze the pupil responses to focal light stimuli and display the results graphically. All 76 locations of Humphrey program 30-2 could be tested twice within 5.5 minutes and the relative sensitivity of the field was determined by comparing the amplitude of pupil constriction or latency time at each stimulus location. The mean pupil responses within annular areas at 3 degrees, 9 degrees, 15 degrees, 21 degrees, and 27 degrees were shown to be linearly related to log stimulus intensity over a 15 dB range under low level mesopic conditions (3.15 asb bowl background). In normal subjects, the superior temporal quadrant usually had the greatest mean pupillomotor response and the inferior nasal quadrant had the least. Pupil responses in the temporal field were larger than corresponding locations in the nasal field. Patients with visual field defects who underwent testing by pupil perimetry showed pupillary deficits in the same location within the field, providing evidence that pupil perimetry may be a useful, objective means of assessing visual field function.
Subject(s)
Optic Neuritis/physiopathology , Reflex, Pupillary/physiology , Visual Field Tests/methods , Visual Fields , Adolescent , Adult , Humans , Image Processing, Computer-Assisted , Middle Aged , Optic Nerve Diseases/physiopathology , Photic Stimulation , SoftwareABSTRACT
Atrophy of orbital fat is a reported complication of localized scleroderma but not of systemic scleroderma. Here we present a case of systemic scleroderma with unilateral enophthalmos. Orbital fat atrophy was the presumed cause on computerized tomography.
Subject(s)
Enophthalmos/complications , Scleroderma, Systemic/complications , Adipose Tissue/pathology , Atrophy , Enophthalmos/diagnostic imaging , Female , Humans , Middle Aged , Scleroderma, Systemic/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
There is a large range of neurologic complications in periarteritis nodosa, but oculomotor motility disorders are rarely seen. Two patients presented with third nerve palsy and one presented with internuclear ophthalmoplegia due to periarteritis nodosa vasculitis. We hypothesize that the third nerve palsy and internuclear ophthalmoplegia was caused by a vascular infarction in the brain stem.
Subject(s)
Oculomotor Nerve Diseases/etiology , Ophthalmoplegia/etiology , Polyarteritis Nodosa/complications , Adolescent , Child , Cyclophosphamide/therapeutic use , Diplopia/etiology , Female , Humans , Male , Polyarteritis Nodosa/drug therapy , Prednisolone/therapeutic useABSTRACT
We present a case of unilateral posterior ischemic optic neuropathy after bilateral radical neck dissection. Etiologic factors are discussed.
Subject(s)
Ischemia/etiology , Neck Dissection/adverse effects , Optic Disk/blood supply , Adult , Blindness/etiology , Evoked Potentials, Visual , Humans , Male , Scotoma/etiology , Visual Acuity , Visual FieldsABSTRACT
Lid lag in Guillain-Barré syndrome is not a well-known feature of the disease. Here we present two cases of Guillain-Barré syndrome with lid lag. In its formation, supranuclear levator dysfunction was the possible cause.
Subject(s)
Eyelid Diseases/physiopathology , Polyradiculoneuropathy/physiopathology , Adult , Eye Movements , Female , Humans , Oculomotor Muscles/physiopathologyABSTRACT
Optic neuropathy in Behçet's disease is rare, despite wide ocular and neurological involvement. Progressive atrophy of the optic disc and severe visual loss is not uncommon in Behçet's disease; however, visual loss due to acute optic neuropathy is less well known. We report three cases of optic neuropathy in Behçet's disease. The clinical picture was variable in our patients, presenting either as acute retrobulbar optic neuritis or anterior optic neuropathy. It is interesting to note that although the neurological picture resembles multiple sclerosis, there seems to be less predilection to optic nerve involvement in Behçet's disease.
