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Third nerve palsy

J Stephen Huff, Everett W Austin
Understanding the anatomy and physiology of the eye, the orbit, and the central connections is key to understanding neuro-ophthalmologic emergencies. Anisocoria is an important sign that requires a systematic approach to avoid misdiagnosis of serious conditions, including carotid dissection (miosis) and aneurysmal third nerve palsy (mydriasis). Ptosis may be a sign of either Horner syndrome or third nerve palsy. An explanation should be pursued for diplopia since the differential diagnosis ranges from the trivial to life-threatening causes...
November 2016: Emergency Medicine Clinics of North America
Jessica Mani Penny Tevaraj, Evelyn Tai Li Min, Raja Azmi Mohd Noor, Azhany Yaakub, Wan Hazabbah Wan Hitam
Neurofibromatosis type 2 usually presents with bilateral acoustic schwannomas. We highlight the rare presentation of neurofibromatosis initially involving third nerve. A 23-year-old Malay female presented with left eye drooping of the upper lid and limitation of upward movement for 8 years. It was associated with right-sided body weakness, change in voice, and hearing disturbance in the right ear for the past 2 years. On examination, there was mild ptosis and limitation of movement superiorly in the left eye...
2016: Case Reports in Ophthalmological Medicine
Kumar Jee Kaul, H V Nataraju
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Jean-Marc Foletti, Luc Wajszczak, Marie Gormezano, Laurent Guyot, Narcisse Zwetyenga, Cyrille Chossegros
INTRODUCTION: Parotid gland duct lithiasis is preferentially managed using minimally-invasive techniques such as sialendoscopy and lithotripsy. However, these 2 techniques cannot remedy all obstructions and other techniques such as the Transoral Stensen's Duct Approach (TSDA) may sometimes be helpful. MATERIAL AND METHODS: A retrospective study of patients treated with TSDA was conducted to evaluate this procedure between 2006 and 2013. Criteria for inclusion were: failures for lithiases (22 patients and 28 lithiases) treated with sialendoscopy and/or lithotripsy for parotid gland duct obstruction...
August 26, 2016: Journal of Cranio-maxillo-facial Surgery
Lachlan J McDowell, Marlene C Jacobson, Wilfred Levin
BACKGROUND: Hypoglossal nerve palsies are infrequent complications of head and neck radiotherapy. Treatments focus on maintaining function and prevention of abnormal airway-related swallowing events. METHODS: A patient with longstanding cranial neuropathies, including bilateral hypoglossal involvement, secondary to chemoradiotherapy for nasopharyngeal carcinoma, experienced repeated episodes of life-threatening complications. Initially, 2 courses of 2 weekly 24-hour intravenous methylprednisolone (IVMP) infusions were administered 2 years apart...
October 5, 2016: Head & Neck
Pinar Arican, Nihal Olgac Dundar, Pinar Gencpinar, Dilek Cavusoglu
Bell's palsy is the most common cause of acute peripheral facial nerve paralysis, but the optimal dose of corticosteroids in pediatric patients is still unclear. This retrospective study aimed to evaluate the efficacy of low-dose corticosteroid therapy compared with high-dose corticosteroid therapy in children with Bell's palsy. Patients were divided into 2 groups based on the dose of oral prednisolone regimen initiated. The severity of idiopathic facial nerve paralysis was graded according to the House-Brackmann Grading Scale...
September 29, 2016: Journal of Child Neurology
S M Yap, B McNamara
Foot drop is a complex symptom with a considerable range in aetiology, severity and prognosis. We aim to characterise the aetiologies of foot drop and assess the diagnostic contribution of neurophysiologic testing (NCS/EMG). Retrospective review of consecutive referrals of foot drop to the Neurophysiology Department in Cork University Hospital was performed over a two year period (January 2012 to December 2013). Of a total of 59 referrals, common peroneal nerve (CPN) palsy comprised only slightly more than half of cases; 3(5%) have central origin; 3(5%) have motor neuron disease...
2016: Irish Medical Journal
Akio Kanda, Kazuo Kaneko, Osamu Obayashi, Atsuhiko Mogami, Itaru Morohashi
Acetabular fracture is usually treated with osteosynthesis. However, in the case of an intra-articular fracture, osteosynthesis can result in arthropathy of the hip joint and poor long-term results, hence, total hip arthroplasty is required. However, in total hip arthroplasty for postoperative acetabular fracture, sciatic nerve palsy tends to develop more commonly than after primary total hip arthroplasty. This is a case report of a 57-year-old Japanese male who had internal skeletal fixation for a left acetabular fracture that had occurred 2 years earlier...
November 2016: Annals of Medicine and Surgery
Angkoon Anuwong, Matteo Lavazza, Hoon Yub Kim, Che-Wei Wu, Stefano Rausei, Vincenzo Pappalardo, Cesare Carlo Ferrari, Davide Inversini, Andrea Leotta, Antonio Biondi, Feng-Yu Chiang, Gianlorenzo Dionigi
The objective is to compare the consequences of routine visualization (RV) and the application of intermitted (I-IONM), standardized (S-IONM), and continuous monitoring (C-IONM) of recurrent laryngeal nerve (RLN) management. RV includes that 698 RLNs managed solely with visual identification. In a second period 777, RLNs were handled by the I-IONM. The third period 768 RLNs monitoring was performed according to the standards. C-IONM via VN stimulation included 626 RLNs. The following issues were analyzed and compared per each period study: RLN identification rate, branching detection, assessment of NRLN, intraoperative recognizable nerve damage, stage thyroidectomy rate, transient or definitive lesions, bilateral nerve palsy, and recovery time...
September 20, 2016: Updates in Surgery
A Caignard, S Leruez, D Milea
Neuro-ophthalmic emergencies can cause life-threatening or sight-threatening complications. Various conditions may have acute neuro-ophthalmic manifestations, including inflammatory or ischemic processes, as well as tumoral, aneurysmal compression or metabolic and systemic diseases. Diplopia related to a partial third nerve palsy with pupillary involvement may reveal an intracranial aneurysm. Abnormalities of conjugate gaze may reveal an inflammatory or ischemic lesion, most often of the brainstem. An intracranial tumor may also manifest itself as a single or multiple oculomotor palsy, or causing various visual field defects, due to optic nerve, chiasm or retrochiasmal involvement...
October 2016: Journal Français D'ophtalmologie
Yuta Murakami, Taku Sato, Shinya Jinguji, Yugo Kishida, Tadashi Watanabe, Osamu Suzuki, Kazuhiko Ikeda, Miyuki Homma, Sanae Midorikawa, Kiyoshi Saito
We report a rare case of primary pituitary lymphoma in a 75-year-old immunocompetent woman. The patient was blind in the right eye and presented with visual disturbance in the left eye that started 2 months previously. She also exhibited right third and fifth cranial nerve palsy. Magnetic resonance imaging(MRI)revealed an intrasellar mass lesion with right cavernous sinus invasion and suprasellar extension with compression of the optic chiasm. The mass lesion was isointense on both T1WI and T2WI, and showed less enhancement than a normal pituitary gland on gadolinium-enhanced T1WI...
September 2016: No Shinkei Geka. Neurological Surgery
Mohamad Gouse, Sandeep Albert, Dan-Barnabas Inja, Manasseh Nithyananth
PURPOSE: Fractures of the humeral shaft are common and account for 3%-5% of all orthopedic injuries. This study aims to estimate the incidence of radial nerve palsy and its outcome when the anterior approach is employed and to analyze the predictive factors. METHODS: The study was performed in the department of orthopaedics unit of a tertiary care trauma referral center. Patients who underwent surgery for acute fractures and nonunions of humerus shaft through an anterior approach from January 2007 to December 2012 were included...
August 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Min Jeong, Hyung-Joo Kim, Seung-Jae Lim, Young-Wan Moon, Yoon-Soo Park
PURPOSE: The purpose of this study is to report the short-term outcomes of revision total hip arthroplasty (THA) using tantalum augments in patients with severe acetabular bone defects. MATERIALS AND METHODS: We retrospectively analyzed 15 revision THAs performed in 15 patients using tantalum augments between June 2010 and December 2013. Acetabular bone defects were Paprosky type IIIA in 7 hips, type IIIB in 7, and type IV in 1. The causes of revision surgery were aseptic loosening in 12 hips and deep infection in 3...
June 2016: Hip Pelvis
George M Ghobrial, Mary L Pisculli, James J Evans, Jurij R Bilyk, Christopher J Farrell
A 33-year-old immunocompetent man developed rapid visual loss and a third nerve palsy secondary to acute rhinosinusitis and intracranial abscess formation. Despite endoscopic drainage of the ethmoid and sphenoid sinuses and empiric broad-spectrum antibiotics, the patient experienced progressive visual and neurological decline and ultimately required craniotomy for drainage of an optic apparatus abscess. Although odontogenic sinusitis rarely results in abscess formation of the visual pathways, early recognition and immediate treatment is imperative to decrease the risk of profound and permanent visual impairment...
August 12, 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
A Maresca, R Fantasia, M Cianforlini, N Giampaolini, S Cerbasi, R Pascarella
PURPOSE: Distal-third diaphyseal fractures of the humerus are often hard to treat due to location and pattern of the fractures, radial nerve injury, and quality of bone and age of patients. The aim of this retrospective study is to propose the best approach and the best surgical technique according to the pattern of extra-articular fracture of the distal humerus. METHODS: We have treated 37 fractures of the distal humerus between January 2010 and July 2015 classified according to the AO classification...
August 12, 2016: Musculoskeletal Surgery
Tsung-Yu Lee, Chih-Yu Ting, Ming-Jen Tsai
No abstract text is available yet for this article.
August 9, 2016: QJM: Monthly Journal of the Association of Physicians
Arash Aryana, Marcin Kowalski, Padraig Gearoid O'Neill, Charles H Koo, Hae W Lim, Asif Khan, Robert B Hokanson, Mark R Bowers, David N Kenigsberg, Kenneth A Ellenbogen
BACKGROUND: Limited data exists on cryoablation of atrial fibrillation (Cryo-AF) using the newly-available third-generation (AFA-ST) cryoballoon. OBJECTIVE: In this multicenter study, we evaluated the safety and efficacy of Cryo-AF using the AFA-ST versus the second-generation (AFA) cryoballoon. METHODS: We examined the procedural safety and efficacy and acute and mid-term results from 355 consecutive patients (72% with paroxysmal AF) who underwent a first-time Cryo-AF using AFA-ST (n=102) or AFA (n=253)...
August 5, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
P Mukherjee, R Huilgol, A Graham, P Fagan
OBJECTIVE: Three cases of internal carotid artery aneurysm affecting the distal cervical segment were retrospectively reviewed. METHODS: Two patients underwent open surgical repair requiring petrous segment exposure for bypass of the affected segment using a Fisch type A lateral skull base approach. The third patient underwent endovascular stenting. RESULTS: There were no cerebrovascular complications post-operatively. Both open repair patients experienced temporary lower cranial nerve palsies...
July 2016: Journal of Laryngology and Otology
Rabih Hage, Sheila R Eshraghi, Nelson M Oyesiku, Adriana G Ioachimescu, Nancy J Newman, Valérie Biousse, Beau B Bruce
BACKGROUND: Pituitary apoplexy (PA) often presents with acute headache and neuro-ophthalmic manifestations, including ocular motility dysfunction (OMD) from cranial nerve palsies (CNPs). Our goal was to describe the epidemiology and outcomes of OMD in a large, single-center series of patients with PA. METHODS: We conducted a retrospective chart review of all patients with PA seen in our pituitary center between January 1995 and December 2012. Presenting neuro-ophthalmic, endocrine, and radiologic data, as well as neuro-ophthalmology follow-up data, were collected...
October 2016: World Neurosurgery
Anupam Singh, Chirag Bahuguna, Ritu Nagpal, Barun Kumar
Third nerve paralysis has been known to be associated with a wide spectrum of presentation and other associated factors such as the presence of ptosis, pupillary involvement, amblyopia, aberrant regeneration, poor bell's phenomenon, superior oblique (SO) overaction, and lateral rectus (LR) contracture. Correction of strabismus due to third nerve palsy can be complex as four out of the six extraocular muscles are involved and therefore should be approached differently. Third nerve palsy can be congenital or acquired...
May 2016: Oman Journal of Ophthalmology
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