Third nerve palsy

Cases of herpes zoster ophthalmicus (HZO) complicated by bilateral ophthalmoplegia are rare, and no cases of bilateral third, fourth, or sixth cranial nerve palsies have been reported. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a rare complication of HZO. We herein report an 80-year-old Japanese woman with right-sided HZO complicated by meningoencephalitis and discuss the pathogenesis of this condition. She developed bilateral third, fourth, and sixth cranial nerve palsies and SIADH almost simultaneously during treatment for HZO...

INTRODUCTION: Chordomas are rare malignant neoplasms that can originate anywhere along the cerebrospinal axis. However, they are most commonly found in the spine, cranium, and sacrococcygeal region. Chordomas can manifest differently depending on their location and most symptoms are a result of local invasion. We present a rare case of intracranial clival chordoma that manifested as isolated unilateral cranial nerve XII (CN XII) palsy. PRESENTATION: A 53-year-old male presented to the neurosurgical clinic with headaches, dysarthria, and pharyngeal pain...

PURPOSE: Although various studies have explored the causes and clinical aspects of cranial nerve palsies, there remains a significant gap in understanding the prognostic factors that influence outcomes. In this study, we sought to address this gap by investigating the incidence, etiologies, clinical courses, and factors associated with long-term recovery, with the aim of enhancing the knowledge base in this field and providing valuable insights for improved patient care. PATIENTS AND METHODS: This retrospective study evaluated the data gathered from subjects who had third, fourth, and sixth cranial nerve palsy at the ophthalmology outpatient clinic of Phramongkutklao Hospital between April 1, 2012, and April 30, 2022...

BACKGROUND: The flexor pronator slide is an effective treatment option for ischemic contracture and contracture related to spastic cerebral palsy, but little is known about the use of the flexor pronator slide in other non-ischemic contractures. I propose a flexor pronator slide to simultaneously correct wrist and finger flexor contractures and preserve the muscle resting length. To avoid overcorrection of the deformity, I propose the use of a wide-awake local anesthesia with no tourniquet (WALANT) procedure, in which the patient is able to continually assist the surgeon in assessing the contracture release and improvement in finger movement...

BACKGROUND AND IMPORTANCE: A subset of invasive pituitary adenomas invade not only the medial wall of the cavernous sinus but can progress superiorly through the cavernous sinus roof at the oculomotor triangle and reach the subarachnoid parapeduncular space. We describe a series of 2 of 3 cases where an endoscopic endonasal approach was used to reach the parapeduncular space through the oculomotor triangle for tumor decompression. Images of the third case are presented. CLINICAL PRESENTATION: Case 1: We present a 2-dimensional surgical video of a recurrent corticotroph adenoma post gamma knife radiotherapy which was invading the left cavernous sinus and extending into the left parapeduncular space...

BACKGROUND: Open reduction and internal fixation with plate is one of the most widely used treatments for distal third humeral shaft fractures. The purpose of this study was to report the outcomes of the treatment of distal third humeral shaft fractures with posterior minimally invasive plate osteosynthesis (MIPO) with segmental isolation of the radial nerve. METHODS: We performed an observational, retrospective, consecutive, monocentric, continuous multioperator study...

Weber's syndrome, named after Hermann Weber, is characterized by midbrain lesions often caused by strokes, resulting in ipsilateral third nerve palsy, including ptosis and pupillary abnormalities, and contralateral hemiplegia. We discuss a case of a 35-year-old lady with cognitive impairment, right hemiparesis, diplopia, left eye ptosis, and lateral eye deviation. MRI of the brain with contrast suggested an acute infarct in the left-sided paramedian region of the midbrain. The oculomotor nucleus and cerebral peduncle were both affected by an abrupt left-sided paramedian midbrain stroke...

INTRODUCTION: Detailed description of infarction of the midbrain is sparse likely due to the complex arterial supply of this region of the brain. Among the ventral midbrain syndromes reported is Claude syndrome. This syndrome caused majorly by a vascular insult to the ventromedial midbrain, characteristically presents with ipsilateral third cranial nerve palsy and contralateral hemiataxia. It is a rare syndrome and only a few cases have been reported since 1912 when it was first described by Henri Claude...

Spontaneous intracerebral hemorrhage commonly affects the brainstem. This report describes a 31-year-old male with hypertension who developed a pontine hemorrhage. The neurological deficits included left-third nerve palsy, right-sided weakness, and disabling tinnitus. Tinnitus is linked to central auditory pathway disruption. Magnetic resonance imaging revealed the hemorrhagic lesion and additional micro-hemorrhages. The International Classification of Functioning, Disability, and Health (ICF) enhances rehabilitation by characterizing multifaceted stroke disability...

UNLABELLED: Introduction : Bell's palsy, characterized by acute onset unilateral facial weakness, is caused by the paralysis of the seventh cranial nerve, which controls the muscles of the face. This condition can result in functional disabilities, and early detection and management are crucial for quick recovery. Awareness was found to be one of the factors associated with early detection and interventions. Therefore, this study aimed to assess the awareness of the population of Al-Qassim, Saudi Arabia, regarding Bell's palsy...

INTRODUCTION: Median nerve injuries occur in approximately 3% of pediatric elbow fracture dislocations. These rare injuries can be difficult to diagnose, and the results are poor in delay cases. Surgical timing is one of the most important prognostic factors. We aimed to present three patients with median nerve palsy who were referred to our clinic late, and according to these cases, we emphasized the expected time frame for exploration based on our anatomical cadaver study. MATERIALS AND METHODS: Between 2008 and 2010, three patients were referred to our clinic because of median nerve paralysis after a treated elbow dislocation...

The use of systemic steroids in managing herpes zoster ophthalmicus-related ophthalmoplegia (HZORO) remains a topic of debate. Here, a case involving third nerve HZORO is highlighted, where a regimen of oral valacyclovir followed by a brief course of oral steroids resulted in significant improvement within days and complete resolution of the palsy within a month of initiating the treatment. This case underscores the need for randomized controlled studies to definitively determine the efficacy of systemic steroids in alleviating or shortening the course of HZORO...

Hepatocellular carcinoma (HCC) is the sixth most common neoplasia and the third leading cause of cancer-associated deaths worldwide. Most cases arise in patients with cirrhosis, and early detection through periodic screening can make it potentially curable. The presence of extrahepatic metastases (EHM) affects treatment decisions and curability. The lungs are the most common site for EHM, followed by lymph nodes, bones, and the adrenal glands. Interestingly, approximately only 15 cases of HCC metastasizing to the pituitary gland have been reported so far...

The efficacy of botulinum toxin injection for the treatment of third, fourth, and sixth nerve palsy was evaluated. PubMed, Scopus, EMBASE, Web of Science, and Google Scholar databases were searched. Data about the duration of palsy (acute vs chronic), cause of the palsy, type of toxin used, mean dose, and other background characteristics were collected. Outcome variables were success rate (defined by alleviation of diplopia or reduction in eye deviation) and standardized mean difference of prism diopter and abduction deficit before and after injection...

PURPOSE: To report a case of (neuro)sarcoidosis presenting solely with recurrent cranial nerve palsies in a 57-year-old Caucasian female. METHODS: Case report with clinical imaging. RESULTS: A 57-year-old female first presented with a right sixth nerve palsy, which resolved spontaneously after 6 months. Three years later she was diagnosed with a sixth nerve palsy in the fellow eye followed by a complete palsy of the left third cranial nerve four months after...

Approximately two-thirds of the Guillain-Barré syndrome (GBS) cases are preceded by upper respiratory tract infection or enteritis. There has been previous documentation of a clear association between Covid-19 and GBS. Covid-19 can affect the nervous tissue either through direct damage or through triggering a host immune response with subsequent development of autoimmune diseases such as GBS. Covid-19 can affect the host`s immune system through the activation and interaction of the T-and B-lymphocytes with subsequent production of antibodies that cross-react with the gangliosides...

INTRODUCTION: Pediatric Rhabdoid Meningioma (RM) are the rarest, but most aggressive subtypes of meningioma, related to a severe prognosis. They account for 1-3% of all intracranial meningiomas. CASE PRESENTATIONS: We report an institutional experience of 3 cases through which we discuss clinical, histological and therapeutic features of this tumour. Two of our patients were female-gendered (3 years old and 1 year and 6 months old), and one male-gendred (16 years old)...

BACKGROUND: Third nerve palsies (TNPs) may not resolve after intervention for intracranial aneurysms that have compressed the nerve. The disability related to this lingering condition has not been assessed with the support of patient self-report. METHODS: A single-institutional retrospective study of patients with TNP who had undergone interventions for intracranial aneurysms. We used residual primary-position diplopia, a narrow zone of single binocular vision, and vision-obscuring ptosis to divide TNP recovery into complete, incomplete nondisabling, and incomplete disabling outcomes based on medical record documentation and patient self-report derived from telephonic interviews...

BACKGROUND: Neuromuscular diseases (NMD) emerged as one of the main side effects of the COVID-19 vaccination. We pooled and summarized the evidence on the clinical features and outcomes of NMD associated with COVID-19 vaccination. METHODS: We comprehensively searched three databases, Medline, Embase, and Scopus, using the key terms covering "Neuromuscular disease" AND "COVID-19 vaccine", and pooled the individual patient data extracted from the included studies...

BACKGROUND: This is the first systematic review of the relationship between humeral shaft fractures and radial nerve palsy in children. The present comprehensive review is aimed at identifying important clinical findings between humeral diaphysis fractures and radial nerve injuries and assessing the effects of treatment. METHODS: We searched electronic bibliographic databases, including PubMed, the Cochrane Library, Scopus, and Web of Knowledge, until March 2022...