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https://www.readbyqxmd.com/read/28820310/orbital-mantle-cell-lymphoma-presenting-as-myasthenia-gravis
#1
Justin Karlin, Travis Peck, Karyn Prenshaw, Craig A Portell, Maria Kirzhner
A 69-year-old man, previously treated with pyridostigmine for myasthenia gravis (manifesting as ptosis and diplopia) was evaluated for several concomitant bilateral anterior orbital masses. Imaging revealed 3 discrete, solid masses within and around the orbits. An incisional biopsy demonstrated atypical lymphocytes positive for CD20 and Cyclin-D1, consistent with mantle cell lymphoma. The patient received induction chemotherapy with a rituximab-based regimen. He experienced resolution of his diplopia and ptosis after one cycle of chemotherapy and achieved complete remission of the orbital masses and myasthenia symptoms after 6 cycles...
August 18, 2017: Orbit
https://www.readbyqxmd.com/read/28820280/review-of-periorbital-nerve-enlargement-and-biopsy-techniques
#2
Valerie H Chen, Brent R Hayek, Hans E Grossniklaus, Ted H Wojno, H Joon Kim
Periorbital nerve enlargement commonly indicates perineural invasion of malignancy or inflammatory conditions. This study reviews the role of supraorbital and infraorbital nerve biopsies in patients presenting with radiographic enlargement and to elucidate the surgical technique involved. A retrospective chart review (1997-2014) was performed at a single tertiary center. Patients with radiographic confirmation of enlarged supraorbital/infraorbital nerves that underwent biopsy were included. Charts were reviewed for: patient demographics and history, clinical symptoms and findings, radiographic findings, surgical method, and treatment...
August 18, 2017: Orbit
https://www.readbyqxmd.com/read/28820159/surgical-treatment-of-superior-oblique-palsy-predictors-of-outcome
#3
Pilar Merino Sanz, José Escribano, Pilar Gómez de Liaño, Rubén Yela
PURPOSE: The purpose of this study was to evaluate the incidence and outcome of surgically treated superior oblique palsy (SOP) and the factors involved in its resolution. METHODS: We performed a retrospective study of 76 patients who underwent surgery for SOP. We recorded data from the physical examination and the number and type of procedures performed. Favorable outcome was defined as resolution of or improvement in torticollis (≤5°) and diplopia in primary position (PP) and downgaze or as vertical deviation (VD) <5 prism diopters (pd) in PP and 10 pd in the oblique diagnostic position...
August 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28811813/osteonecrosis-in-the-both-femoral-heads-in-a-patient-with-neuro-behcet-s-disease
#4
Asuman Orhan Varoglu, Asude Aksoy
Neuro-Behçet's disease (NBD) is a rare clinical entity that frequently presents neuro-psychiatric symptoms, and mesodiencephalic and pontobulbar lesions. There is only one published report about osteonecrosis in NBD. We report a patient whose first presentation was neurological NBD with presenting bilateral femoral heads osteonecrosis. A 36-year-old male was hospitalized with gait disorder, diplopia and speech disorder. The past medical history of the patient was unremarkable. The MR image showed mesencephalic lesion with oedemaas a hyperintense area...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28806384/transient-amaurosis-and-diplopia-after-inferior-alveolar-nerve-block
#5
Onur Odabaşi, Onur Şahin, Mehmet Emrah Polat
A 40-year-old female patient was admitted to the authors' oral and maxillofacial clinic for removal of her lower left second molar under local anesthesia. The patient's medical history revealed that she had cardiac arhythmia and hypertension. Inferior alveolar nerve block was achieved using 2 mL of sefacaine (%3 mepivacaine HCL, without epinephrine). The patient complained of loss of vision in her left eye. All procedures were stopped immediately. Within 2 minutes the patient reported diplopia. All of the symptoms disappeared about 5 minutes after initial observation...
August 10, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28806382/orbital-cellulitis-following-orbital-blow-out-fracture
#6
Je Yeon Byeon, Hwan Jun Choi
Orbital cellulitis and abscess have been described in the literature as complication that usually occur secondary to infection in the maxillary, ethmoidal, and frontal sinuses. If left untreated, it can lead to blindness, cavernous sinus thrombosis, meningitis, or cerebral abscess. Orbital fractures are a common sequela of blunt orbital trauma, but are only rarely associated with orbital cellulitis. So, the authors present rare orbital cellulitis after orbital blow-out fracture. A 55-year-old Asian complains of severe orbital swelling and pain on the left side...
August 10, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28801336/isolated-clival-metastasis-a-rare-presentation-of-renal-cell-carcinoma
#7
Anil Mani, Priyank Yadav, Vimal Kumar Paliwal, Hira Lal
Renal cell carcinoma accounts for 3% of all adult malignancies. Usual sites of metastasis are lymph nodes, lungs, bone, liver and brain. We describe a patient who presented with complaints of holocranial headache and diplopia. MRI of the head showed a clival-based lesion with associated bony erosion. With suspicion of a metastatic lesion, an ultrasonogram of the abdomen was done which showed a left renal mass that enhanced on contrast-enhanced CT. There were no other metastatic foci. Patient underwent radiotherapy for the clival lesion...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28800343/microsaccade-dysfunction-and-adaptation-in-hemianopia-after-stroke
#8
Ying Gao, Bernhard A Sabel
BACKGROUND: Besides the reduction of visual field size, hemianopic patients may also experience other poorly understood symptoms such as blurred vision, diplopia, or reduced visual acuity, which may be related to microsaccade function. OBJECTIVE: To determine (i) if microsaccades are altered in hemianopia; (ii) how altered microsaccade features correlate with visual performances; and (iii) how their direction relates to visual field defect topography. METHODS: In this case-control study, microsaccades of hemianopic stroke patients (n = 14) were assessed with high-resolution eye-tracking technique, compared with those of healthy controls (n = 14), and correlated with visual performances, visual field defect parameters and lesion age...
2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28797015/pediatric-orbital-blowout-fractures
#9
Stella Y Chung, Paul D Langer
PURPOSE OF REVIEW: The current study reviews the recent literature on pediatric orbital blowout fractures and provides guidelines on their management. RECENT FINDINGS: The most common problem among patients requiring surgical revision of a previously repaired orbital floor fracture is an improperly placed orbital floor implant, usually erroneously placed under the posterior bony ledge. Although the transconjunctival incision can be combined with a lateral canthotomy and cantholysis, excellent surgical exposure can be obtained without the need for these latter relaxing maneuvers...
September 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28794532/local-anaesthetic-systemic-toxicity-following-oral-ingestion-in-a-child-revisiting-dibucaine
#10
Raylene Dias, Nandini Dave, Milind S Tullu, Chandrahas T Deshmukh
Dibucaine, a potent and toxic local anaesthetic, although currently withdrawn by the United States Food and Drug Administration for use as a spinal anaesthetic, continues to remain available in many over-the-counter topical formulations. Systemic toxicity following oral ingestion of local anaesthetics is rare. We report a case of accidental ingestion of dibucaine (ear drops) in a 7-year-old child who developed diplopia, giddiness, ventricular premature contractions and a right bundle branch block. We also present a brief discussion on the pharmacologic and toxicity profile of dibucaine, the Naranjo algorithm for assessing causality in case of adverse drug reactions and a review of current guidelines on the management of local anaesthetic systemic toxicity...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28790098/orbital-multiple-myeloma-a-diagnostic-challenge
#11
Evelyn Tai, See Khim Sim, Juhara Haron, Wan-Hazabbah Wan Hitam
Orbital involvement in multiple myeloma is unusual. We describe the case of an 85-year-old woman who presented with right eye proptosis, reduced visual acuity and diplopia. Computed tomography showed a lobulated, enhancing soft tissue mass arising from the right greater wing of the sphenoid with intraconal, lacrimal gland and ocular muscle involvement. Histopathology revealed predominantly atypical plasma cells in a background of reactive lymphocytes, with monoclonality towards kappa light chain protein, suggestive of multiple myeloma...
August 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28775108/opaque-intraocular-lens-for-correction-of-intractable-diplopia-and-torticollis
#12
Valentin Huerva, Cristina Pont, Diego Castanera
No abstract text is available yet for this article.
August 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28774524/clinical-profiles-and-surgical-outcomes-of-adult-esotropia
#13
Mikel Mikhail, Michael Flanders
OBJECTIVE: The aim of this study was to describe the clinical features and surgical outcomes of teenage and adult patients with esotropia undergoing strabismus surgery with adjustable sutures. METHODS: Seventy-three patients were included in this retrospective, cohort study. Patients were stratified into group 1 (35 with childhood-onset esotropia [CET]) and group 2 (38 with adult-onset esophoria-tropia [EPT]). Preoperative immediate, 2-week, and 4-6-month postoperative measurements of ocular alignment, as well as fusional testing, were performed...
August 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/28770346/steroid-intra-trochlear-injection-for-the-treatment-of-acquired-brown-syndrome-secondary-to-trochleitis
#14
Giuseppe Giannaccare, Laura Primavera, Chiara Maiolo, Michela Fresina, Emilio C Campos
PURPOSE: To evaluate the outcomes of early intra-trochlear steroid injections in patients with acquired Brown syndrome secondary to trochleitis (ABSST). METHODS: Retrospective analysis from medical charts of patients diagnosed as affected by unilateral ABSST from January 2008 to June 2015, and treated according to our Institution protocol: intra-trochlear injection of 1ml of triamcinolone acetonide 40 mg/ml is performed under sterile conditions. In cases of no resolution/improvement within 1 month, further monthly injections are performed up to a maximum number of three...
August 2, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28770205/fatal-mycotic-aneurysm-of-the-basilar-artery-caused-by-aspergillus-fumigatus-in-a-patient-with-pituitary-adenoma-and-meningitis
#15
Martin Winterholler, Roland Coras, Walter Geißdörfer, Rudolf Rammensee, Philipp Gölitz, Christian Bogdan, Roland Lang
Fungal infections of the central nervous system (CNS) frequently occur in immunosuppressed patients. Here, we describe the case of an immunocompetent 64-year-old man who presented with diplopia, right-sided hemiparesis, and a mild headache after cleaning and replacing nesting boxes of wild birds during the preceding months. Lumbar puncture revealed pleocytosis, elevated protein, and lactate levels in the cerebrospinal fluid (CSF). Initial imaging showed ischemia in the left thalamus and an enlargement of the sellar region...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28760921/clinical-reasoning-a-22-year-old-man-with-diplopia
#16
Chelsea Meyer, DonRaphael P Wynn, Stefan M Pulst, Ricky Chen, Kathleen Digre
No abstract text is available yet for this article.
August 1, 2017: Neurology
https://www.readbyqxmd.com/read/28759293/superior-and-lateral-rectus-myopexy-for-acquired-adult-distance-esotropia-a-one-size-fits-all-surgery
#17
Yair Morad, Eran Pras, Achia Nemet
AIM: To evaluate the results of bilateral lateral rectus to superior rectus myopexy for the treatment of acquired adult distance esotropia. METHODS: The charts of all adult patients who were operated for esotropia by the first author at the Department of Ophthalmology, Assaf Harofeh Medical Center, Tel Aviv University, Zrifin, Israel, between the years 2010-2015 were analyzed. Patients with the following inclusion criteria were included: acquired esotropia (not present during childhood); deviation greater for distance than near by at least 4 prism diopters (PD); slight abduction deficit in one or both eyes and/or displacement of the lateral rectus downwards as evident by CT/MRI with or without superior rectus nasal shift and no neurologic abnormalities such as cranial nerve palsies or other...
July 31, 2017: Strabismus
https://www.readbyqxmd.com/read/28753216/strabismus-after-ocular-surgery
#18
Ethan K Sobol, Jamie B Rosenberg
Many types of ocular surgery can cause diplopia, including eyelid, conjunctival, cataract, refractive, glaucoma, retinal, and orbital surgery. Mechanisms include direct injury to the extraocular muscles from surgery or anesthesia, scarring of the muscle complex and/or conjunctiva, alteration of the muscle pulley system, mass effects from implants, and muscle displacement. Diplopia can also result from a loss of fusion secondary to long-standing poor vision in one eye or from a decompensation of preexisting strabismus that was not recognized preoperatively...
July 28, 2017: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28748855/clinical-characteristics-and-endoscopic-endonasal-removal-of-foreign-bodies-within-sinuses-orbit-and-skull-base
#19
Yi-Hui Wen, Wei-Jian Hou, Wen-Bin Lei, Feng-Hong Chen, Xiao-Lin Zhu, Zhang-Feng Wang, Ren-Qiang Ma, Wei-Ping Wen
BACKGROUND: Foreign bodies within the sinuses, orbit, and skull base (FBSOS) are rare; hence, diagnosis and management guidelines are lacking. Endoscopic sinus surgery (ESS) removal is preferred because of the less invasiveness and minimal morbidity. This study was designed to summarize clinical experience with ESS management of FBSOS. METHODS: We retrospectively reviewed clinical manifestations, imaging findings, treatment, and outcomes in consecutive patients with ESS removal of FBSOS between 2004 and 2015 at a tertiary academic medical center...
August 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28747844/posttravmatik-frontoetmoidal-mukopiyosel
#20
Abdulvahap Akyiğit, Öner Sakallıoğlu, Cahit Polat, Alperen Kayalı, Erol Keleş
Paranasal sinus mucoceles are mucus-containing cystic structures with an epithelial lining that completely fills in the paranasal sinuses. Although they are benign in nature, they may result in the destruction of the surrounding bony structures over time. Clinical findings such as exophthalmia, visual impairment, and diplopia occur due to pressure of the fronto-ethmoidal mucocele on the orbita. Currently, the endoscopic intranasal approach is preferred in the treatment of paranasal sinus mucoceles due to its minimal morbidity and low recurrence rates...
June 2017: Türk Pediatri Arşivi
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