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Fourth nerve palsy

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https://www.readbyqxmd.com/read/29770635/clinical-course-and-prognostic-factors-of-acquired-third-fourth-and-sixth-cranial-nerve-palsy-in-korean-patients
#1
Kiyoung Kim, Sung Rae Noh, Min Seok Kang, Kyung Hyun Jin
PURPOSE: This study aimed to evaluate the clinical course and prognostic factors of acquired third, fourth, and sixth cranial nerve (CN) palsy grouped according to etiology. METHODS: This study involved a retrospective review of the medical records of 153 patients who were diagnosed with acquired paralytic strabismus from January 2004 to July 2015. Outcomes, recovery rates, and time to recovery were investigated according to the affected CN: CN3, CN4, and CN6 palsies...
March 20, 2018: Korean Journal of Ophthalmology: KJO
https://www.readbyqxmd.com/read/29701558/syringobulbia-in-pediatric-patients-with-chiari-malformation-type-i
#2
Arnold H Menezes, Jeremy D W Greenlee, Brian J Dlouhy
OBJECTIVE Syringobulbia (SB) is a rare entity, with few cases associated with Chiari malformation type I (CM-I) in the pediatric population. The authors reviewed all pediatric cases of CM-I-associated SB managed at their institution in order to better understand the presentation, treatment, and surgical outcomes of this condition. METHODS A prospectively maintained institutional database of craniovertebral junction abnormalities was analyzed to identify all cases of CM-I and SB from the MRI era (i.e., after 1984)...
April 27, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29701419/carotid-paraganglioma-classical-surgical-technique
#3
Bárbara Pereira, Manuel Fonseca, Anabela Gonçalves, João Alegrio, Óscar Gonçalves
INTRODUCTION: A carotid body tumor is a rare neoplasm, generally benign, that predominantly affects people between their fourth and fith decades of life. It manifests as a pulsatile and generally painless cervical mass with firm consistency, located below the angle of the jaw. Clinically it can cause localized pain, dysphagia, hiccups, hoarseness and hypersensitive carotid body syndrome. Surgery is the treatment of choice, bearing in mind the possibility of malignant transformation, peritumoral invasion and metastasis...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29692521/clinicoradiological-aspects-of-pontine-tegmental-cap-dysplasia-case-report-of-a-rare-hindbrain-malformation
#4
Aanchal Bhayana, Sunil K Bajaj, Ritu N Misra, S Senthil Kumaran
Malformations involving the brainstem are very rare and present with a varied spectrum of clinical symptoms due to multiple cranial nerve palsies and pyramidal tract involvement. Of these, pontine tegmental cap dysplasia is a very unusual malformation, characterized by ventral pons hypoplasia and an ectopic dorsal band of tissue, projecting into the fourth ventricle, from dorsal pontine tegmentum. A 4-year-old male child, presenting with left facial nerve palsy, revealed hypoplastic ventral pons and an ectopic structure on magnetic resonance imaging (MRI)...
January 2018: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29660028/reoperation-for-medulloblastoma-prior-to-adjuvant-therapy
#5
Prayash Patel, David Wallace, Frederick A Boop, Brandy Vaughn, Giles W Robinson, Amar Gajjar, Paul Klimo
BACKGROUND: Surgery remains an integral part of the treatment of medulloblastoma. We present our experience with repeat surgery for this tumor before initiation of adjuvant therapy. OBJECTIVE: To report what was found intraoperatively and where at time of second-look surgery and detail any postoperative events or readmissions within 90 days of surgery. METHODS: Two separate institutional databases were queried to identify patients who underwent repeat resection of suspected residual medulloblastoma from January 2003 to January 2017...
April 11, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29593631/acute-hemorrhagic-encephalitis-responding-to-combined-decompressive-craniectomy-intravenous-immunoglobulin-and-corticosteroid-therapies-association-with-novel-ranbp2-variant
#6
Abdulla Alawadhi, Christine Saint-Martin, Farhan Bhanji, Myriam Srour, Jeffrey Atkinson, Guillaume Sébire
Background: Acute hemorrhagic encephalomyelitis (AHEM) is considered as a rare form of acute disseminated encephalomyelitis characterized by fulminant encephalopathy with hemorrhagic necrosis and most often fatal outcome. Objective: To report the association with Ran Binding Protein ( RANBP2) gene variant and the response to decompressive craniectomy and high-dose intravenous methylprednisolone (IVMP) in life-threatening AHEM. Design: Single case study...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29468002/idiopathic-non-traumatic-facial-nerve-palsy-bell-s-palsy-in-neonates-an-atypical-age-and-management-dilemma
#7
Abdulhafeez M Khair, Khalid Ibrahim
Idiopathic (Bell's) palsy is the commonest cause of unilateral facial paralysis in children. Although being idiopathic by definition, possible infectious, inflammatory, and ischemic triggers have been suggested. Bell's palsy is thought to be responsible for up to three-fourths of cases of acute unilateral facial paralysis worldwide. The diagnosis has to be reached after other causes of acute peripheral palsy have been excluded. However, it is rarely described in neonates and young infants. Steroids may have some role in treatment, but antiviral therapies have doubtful evidence of benefit...
January 2018: Oman Medical Journal
https://www.readbyqxmd.com/read/29467180/ocular-neuromyotonia
#8
Ricardo Soares-Dos-Reis, Ana Inês Martins, Ana Brás, Anabela Matos, Conceição Bento, João Lemos
Ocular neuromyotonia is a rare, albeit treatable, ocular motor disorder, characterised by recurrent brief episodes of diplopia due to tonic extraocular muscle contraction. Ephaptic transmission in a chronically damaged ocular motor nerve is the possible underlying mechanism. It usually improves with carbamazepine. A 53-year-old woman presented with a 4-month history of recurrent episodes of binocular vertical diplopia (up to 40/day), either spontaneously or after sustained downward gaze. Between episodes she had a mild left fourth nerve palsy...
February 21, 2018: Practical Neurology
https://www.readbyqxmd.com/read/29450486/differentiating-acute-and-subacute-vertical-strabismus-using-different-head-positions-during-the-upright-supine-test
#9
João Lemos, Adnan Subei, Mário Sousa, César Nunes, Luís Cunha, Christopher Glisson, Eric Eggenberger
Importance: Accurate clinical differentiation between skew deviation and fourth nerve palsy (4NP) is critical in the acute and subacute settings. Objective: To determine the sensitivity and specificity of the upright-supine test to detect vertical misalignment changes using different head positions for the diagnosis of acute or subacute skew deviation vs 4NP. Design, Setting, and Participants: This multicenter study enrolled consecutive patients from Coimbra University Hospital Centre, Coimbra, Portugal, and Michigan State University, Lansing, within 2 months of presenting with vertical diplopia and diagnosed as having skew deviation or acquired unilateral 4NP...
April 1, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29426788/approach-to-a-patient-with-diplopia-in-the-emergency-department
#10
Edward Margolin, Cindy T Y Lam
BACKGROUND: Diplopia can be the result of benign or life-threatening etiologies. It is imperative for the emergency physician to be proficient at assessing diplopia and recognize when urgent referral or neuroimaging is required. OBJECTIVE: The first part of this review highlights a simple framework to arrive at the appropriate disposition of diplopic patients presenting to the emergency department (ED). The second part of this review provides more detail and further management strategies...
February 6, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29208731/misleading-signs-in-acute-vertigo
#11
Sean Lance, Stuart Scott Mossman
The acute vestibular syndrome is common and usually has a benign cause. Sometimes, however, even experienced neurologists can find it difficult to determine the cause clinically. Furthermore, neuroimaging is known to be insensitive.We describe two cases of acute vestibular syndrome where conflicting clinical findings contributed to a delay in making the correct diagnosis. The first patient with symptomatic vertigo had signs consistent with horizontal benign paroxysmal positional vertigo but also had an abnormal horizontal head impulse test, superficially suggesting acute vestibular neuritis but later accounted for by the finding of a vestibular schwannoma (acoustic neuroma)...
April 2018: Practical Neurology
https://www.readbyqxmd.com/read/29112680/diagnostic-dilemmas-in-fourth-nerve-palsies
#12
COMMENT
R Michael Siatkowski
No abstract text is available yet for this article.
December 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/29102606/incidence-and-etiology-of-presumed-fourth-cranial-nerve-palsy-a-population-based-study
#13
MULTICENTER STUDY
Eniolami O Dosunmu, Sarah R Hatt, David A Leske, David O Hodge, Jonathan M Holmes
PURPOSE: To determine the incidence of isolated, presumed fourth nerve palsy in a defined population, and to report the frequency of each cause. DESIGN: Retrospective, population-based case series. METHODS: A population-based database was used to identify all cases of isolated fourth nerve palsy in Olmsted County, Minnesota, USA diagnosed over a 15-year period (January 1, 1978 to December 31, 1992). The most likely etiology was determined by review of the entire medical record by 2 ophthalmologists...
January 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28955030/gradenigo-s-syndrome-in-a-patient-with-chronic-suppurative-otitis-media-petrous-apicitis-and-meningitis
#14
Nicholas Taklalsingh, Franco Falcone, Vinodkumar Velayudhan
BACKGROUND Gradenigo's syndrome includes the triad of suppurative otitis media, ipsilateral sixth (abducens) cranial nerve palsy and facial pain in the distribution of the fifth (trigeminal) cranial nerve. Gradenigo's syndrome is rare, and the diagnosis is easily overlooked. This case is the first to report Gradenigo's syndrome presenting with meningitis on a background of chronic suppurative otitis media (CSOM) and petrous apicitis (apical petrositis). CASE REPORT A 58-year-old male African American presented with headaches and confusion...
September 28, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28904218/early-onset-sixth-nerve-palsy-with-eccentric-fixation
#15
Kaajal D Nanda, Eve Lacey, Alki Liasis, Ken K Nischal
PURPOSE: To report four cases of early onset sixth-nerve palsy all of whom had eccentric fixation. METHODS: A retrospective case note review was undertaken of all cases presenting to the senior author's private and NHS practice with early onset sixth palsy between 2006 and 2012. As well as demographic information, details of ophthalmic, orthoptic, electrophysiological examinations, and radiological investigations that were extracted from the records. RESULTS: Four children with unilateral or asymmetric early onset sixth-nerve palsy were identified, of which three were congenital...
January 2017: American Orthoptic Journal
https://www.readbyqxmd.com/read/28845325/ocular-causes-of-abnormal-head-position-strabismus-clinic-data
#16
Kadriye Erkan Turan, Hande Taylan Şekeroğlu, İrem Koç, Esra Vural, Jale Karakaya, Emin Cumhur Şener, Ali Şefik Sanaç
OBJECTIVES: To determine the most common ocular causes and types of abnormal head position (AHP) and describe their clinical features. MATERIALS AND METHODS: Patients with AHP who had been followed in the strabismus unit were retrospectively reviewed. Demographic features and orthoptic characteristics were recorded. RESULTS: A total of 163 patients including 61 women (37.4%) and 102 men (62.6%), with a mean age of 19.9±18.3 were recruited...
August 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28772000/stroke-risk-among-adult-patients-with-third-fourth-or-sixth-cranial-nerve-palsy-a-nationwide-cohort-study
#17
MULTICENTER STUDY
Tyler Hyungtaek Rim, Jinu Han, Yoon Seong Choi, Taekjune Lee, Sung Soo Kim
PURPOSE: This study sought to determine whether isolated third, fourth and sixth cranial nerve palsies (NPs) are associated with increased short- and long-term risk of a subsequent stroke. METHODS: This was a nationwide retrospective propensity score-matched cohort study. A cohort of patients with NP (n = 466) and a randomly selected, propensity-matched control cohort (n = 2281) were extracted from the Korean national insurance claim database. Subjects were tracked for 5 years total, subdivided into periods of 0-1 years, 1-3 years and 3-5 years...
November 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28759288/neurological-imaging-in-acquired-cranial-nerve-palsy-ophthalmologists-vs-neurologists
#18
COMPARATIVE STUDY
Tessa Klein Hesselink, Mari Gutter, Jan Roelof Polling
PURPOSE: Cranial nerve palsies often require neurological imaging by MRI. Guidelines on whether or not to utilize MRI have been absent or lack clarity. In daily practice, both neurologists and ophthalmologists treat patients with cranial nerve palsy and determine whether neuro-imaging is required. There appear to be differences in policy with respect to neuro-imaging. The question, which will be answered in this study, is the following: to what extent do differences in policy exist between ophthalmologists and neurologists regarding imaging by MRI of patients with acquired ocular cranial nerve palsy? METHOD: PubMed database was searched for literature on acquired cranial nerve palsy and MRI scanning performed by ophthalmologists and neurologists...
September 2017: Strabismus
https://www.readbyqxmd.com/read/28743241/complete-ophthalmoplegia-complete-ptosis-and-dilated-pupil-due-to-internal-carotid-artery-dissection-as-the-first-manifestation-of-takayasu-arteritis
#19
H M M T B Herath, S P Pahalagamage, D Withana, Sunethra Senanayake
BACKGROUND: Takayasu arteritis is a rare, chronic large vessel vasculitis involving the aorta and its primary branches. As the disease progresses, the active inflammation of large vessels leads to dilation, narrowing and occlusion of the arteries. Arterial dissection is due to separation of the layers of the arterial wall resulting in a false lumen, where blood seeps into the vessel wall. Neurological sequelae of intracranial arterial dissection results from cerebral ischemia due to thromboembolism and hypo perfusion...
July 25, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28706764/neuroradiological-endovascular-intervention-for-diplopia-in-a-case-of-aneurysmal-aberrant-regeneration-of-the-third-nerve
#20
Anupam C A Rao, Saumil A Shah, Benjamin W C Sim, Steven T H Yun, Neeranjali S Jain, Yashar Kalani, Ian C Francis
Aberrant regeneration of the third nerve occurs as a result of synkinetic 'miswiring' of the third nerve following its injury, such as in third cranial nerve palsy due to tumor, trauma, or aneurysm. The case presented is an elderly woman with new vertical diplopia, which led to a diagnosis of a third cranial nerve palsy, thought to be caused by a 5 mm blister aneurysm of the posterior communicating artery. However, neuro-ophthalmological evaluation diagnosed aberrant regeneration of the third nerve, with the cause of her new vertical diplopia being an ipsilateral fourth nerve palsy...
June 12, 2017: Curēus
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