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Sixth nerve palsy

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https://www.readbyqxmd.com/read/29044089/congenital-sixth-nerve-palsy-with-associated-anomalies
#1
Nirupama Kasturi
Congenital abduction deficit is most likely due to Duane's retraction syndrome as congenital abducens nerve palsy is very rare. We report two cases of infantile abduction deficit due to sixth nerve palsy associated with other anomalies to highlight the importance of including neuroimaging in the evaluation of an infant presenting with a limitation of abduction.
October 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28987313/pneumocephalus-and-sixth-nerve-palsy-after-epidural-steroid-injection-case-report-and-review-of-the-literature
#2
Wendy F Li, Kyle Kovacs, Adeniyi A Fisayo
BACKGROUND: Pneumocephalus has been described as an unintended outcome after epidural injections. However, oculomotor palsy from pneumocephalus after epidural injection is very rare. CASE REPORT: We report a case of pneumocephalus-induced sixth nerve palsies and diplopia in an 87-year-old woman after epidural steroid injection. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Pneumocephalus-induced oculomotor palsy is a rare complication after epidural injection, a commonly performed medical procedure...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28969214/isolated-sixth-cranial-nerve-palsy-in-a-case-of-severe-pre-eclampsia-presenting-as-postpartum-diplopia
#3
Aarti Yevale, Akhila Vasudeva, Anjali Mundkur, Pratap Kumar, Arvind Prabhu
Visual symptoms in pregnancy are ominous. The spectrum of ocular symptoms seen in pre-eclampsia includes blurring of vision, scotoma, hemianopia and even total cortical blindness. Diplopia, though rare has also been reported in cases of pre-eclampsia and occurs due to pathological changes affecting the 6(th) cranial nerve. Ocular symptoms of pre-eclampsia usually regress after delivery but occasionally may present in the postpartum period. We present a case of a 34-year-old lady with severe pre-eclampsia at 31 weeks of gestation with diplopia presenting seven days post caesarean section...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28955030/gradenigo-s-syndrome-in-a-patient-with-chronic-suppurative-otitis-media-petrous-apicitis-and-meningitis
#4
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
#5
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
#6
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/28794092/optic-disc-swelling-in-a-patient-with-tuberculous-meningitis-a-diagnostic-challenge
#7
Hanis Zuhaimy, Sue Ngein Leow, Suresh K Vasudevan
We discuss the diagnostic challenge in an adult patient presented with purely ocular symptoms diagnosed with tuberculous meningitis (TBM). A 38-year-old woman presented with bilateral painless blurring of vision. There were bilateral sixth cranial nerve palsy and bilateral optic disc swelling. Optic nerve function tests were normal. Patient was lucid with no signs of meningism. Brain imaging were normal. She had a positive Mantoux test, high erythrocyte sedimentation rate but no clinical evidence of active pulmonary tuberculosis infection...
August 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28772000/stroke-risk-among-adult-patients-with-third-fourth-or-sixth-cranial-nerve-palsy-a-nationwide-cohort-study
#8
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...
August 3, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28758185/cystic-chordoma-of-cavernous-sinus
#9
Prashant Sathe, Amit Mahore, Aadil Chagla
Chordomas are the tumors commonly involving base of skull which are predominantly solid in consistency. A cystic chordoma of cavernous sinus is an extremely rare entity and has never been reported. We report a 26- year-old male presenting with gradually progressive right sided sixth nerve palsy and headache. Computerized tomography (CT) scan and Magnetic resonant imaging (MRI ) scan of brain showed a cystic lesion in right cavernous sinus.Patient was successfully treated using transnasal endoscopic trans-sphenoidal approach ...
June 14, 2017: Turkish Neurosurgery
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
#10
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/28720313/binocular-diplopia-in-a-tertiary-hospital-aetiology-diagnosis-and-treatment
#11
P Merino, D Fuentes, P Gómez de Liaño, M A Ordóñez
OBJECTIVE: To study the causes, diagnosis and treatment in a case series of binocular diplopia. MATERIAL AND METHOD: A retrospective chart review was performed on patients seen in the Diplopia Unit of a tertiary centre during a one-year period. Diplopia was classified as: acute≤1 month since onset; subacute (1-6 months); and chronic (>6 months). Resolution of diplopia was classified as: spontaneous if it disappeared without treatment, partial if the course was intermittent, and non-spontaneous if treatment was required...
July 15, 2017: Archivos de la Sociedad Española de Oftalmología
https://www.readbyqxmd.com/read/28665866/intracranial-aneurysms-of-neuro-ophthalmologic-relevance
#12
Jonathan A Micieli, Nancy J Newman, Daniel L Barrow, Valérie Biousse
BACKGROUND: Intracranial saccular aneurysms are acquired lesions that often present with neuro-ophthalmologic symptoms and signs. Recent advances in neurosurgical techniques, endovascular treatments, and neurocritical care have improved the optimal management of symptomatic unruptured aneurysms, but whether the chosen treatment has an impact on neuro-ophthalmologic outcomes remains debated. EVIDENCE ACQUISITION: A review of the literature focused on neuro-ophthalmic manifestations and treatment of intracranial aneurysms with specific relevance to neuro-ophthalmologic outcomes was conducted using Ovid MEDLINE and EMBASE databases...
June 29, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28602444/abducens-nerve-palsy-in-gestational-hypertension-a-case-report-and-review-of%C3%A2-the%C3%A2-literature
#13
Albaro J Nieto-Calvache, Sara Loaiza-Osorio, José Casallas-Carrillo, María F Escobar-Vidarte
BACKGROUND: Headache, blurring of vision, and confusion are common neurologic symptoms of hypertensive disorders of pregnancy, whereas abducens nerve palsy during pregnancy is an extremely rare condition. CASE: A 28-year-old woman with gestational hypertension presented isolated sixth cranial nerve palsy after delivery. Neither simple resonance nor angioresonance showed alterations. No other specific pathology was found. Symptoms of abducens nerve palsy resolved spontaneously...
June 8, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28589111/acute-otitis-media-induced-gradenigo-syndrome-a-dramatic-response-to-intravenous-antibiotic
#14
Tayebeh Kazemi
INTRODUCTION: Petrositis is a rare but severe complication of acute otitis media and mastoiditis. Despite efficient antibiotic therapy, there are still reports of both intratemporal and intracranial complications of otitis media with the potential risk of high morbidity and mortality. Petrositis has traditionally been treated with surgery, but recent advances in imaging, with improved antibiotic treatment, allow more conservative management. CASE REPORT: In this case report we describe the clinical course and treatment of a 33-year-old man with petrous apicitis who presented with severe otalgia, retro-orbital pain, and sixth cranial nerve palsy Gradenigo syndrome...
May 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28527856/a-bloody-mess
#15
Michael C Brodsky, Valérie Biousse
A 15-year-old girl presented with a unilateral sixth nerve palsy and papilledema following a severe headache. MR imaging showed thrombosis of the superior sagittal sinus and proximal right transverse sinus that were attributed to oral contraceptive use after a coagulation workup was negative. Systemic anticoagulation caused a hemorrhagic papillopathy in both eyes, raising the question as to whether anticoagulation should be discontinued. Diagnostic and management issues regarding cerebral venous sinus thrombosis with secondary intracranial hypertension are discussed...
May 17, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28498375/neuro-ophthalmologic-manifestations-of-cholangiocarcinoma-a-case-series
#16
G Rico, S V Smith, Y Siddiqui, A Whyte, D Gombos, A G Lee
PurposeTo describe the neuro-ophthalmologic findings of cholangiocarcinoma.MethodsWe report a retrospective chart review of cholangiocarcinoma patients presenting at two tertiary care centers in the Texas Medical Center.ResultsFive patients with neuro-ophthalmologic symptoms related to cholangiocarcinoma were identified. One patient presented with diplopia due to metastasis to the left medial rectus muscle, two patients had metastasis to the occipital lobe resulting in homonymous hemianopsia, one patient had involvement of the clivus resulting in sixth nerve palsy, and one presented with a hypercoagulable state-related stroke causing a homonymous hemianopsia and visual hallucinations...
August 2017: Eye
https://www.readbyqxmd.com/read/28474987/idiopathic-hypertrophic-pachymeningitis-mimicking-hemicrania-continua-an-unusual-clinical-case
#17
Antonio Russo, Marcello Silvestro, Mario Cirillo, Alessandro Tessitore, Gioacchino Tedeschi
Background Hemicrania continua (HC) is a primary headache syndrome characterized by a unilateral, moderate, continuous headache with exacerbations marked by migrainous and cranial autonomic symptoms. However, clinical phenotypes similar to primary HC may be subtended by several disorders. Case report We report the case of a 62-year-old man experiencing, over the previous year, a headache completely consistent with HC and its absolute responsiveness to indomethacin therapy. Later, the patient developed diplopia caused by sixth cranial nerve palsy ipsilateral to headache...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28474478/incomplete-cavernous-sinus-syndrome-as-the-initial-manifestation-of-a-previously-undetected-metastatic-prostate-adenocarcinoma
#18
María Machío Castelló, Diego Escobar Montatixe, Carlos Cenjor Español, José Miguel Villacampa Aubá, Julia Montoya Bordón, Rafael Carias Calix, Rafael Sáez Pinel
BACKGROUND: Cavernous sinus syndrome presents as unilateral ophthalmoplegia associated with sympathetic denervation, pain, paresthesias, and V1 and V2 distribution numbness. The etiology may be vascular, inflammatory, infectious, and, less commonly, neoplastic (metastatic). METHODS: We report a patient with incomplete cavernous sinus syndrome as the initial manifestation of previously undetected metastatic prostate adenocarcinoma. RESULTS: A 59-year-old man presented with a 2-month history of left hemicranial headaches with ptosis and binocular diplopia...
May 5, 2017: Head & Neck
https://www.readbyqxmd.com/read/28473604/recurrent-painful-ophthalmoplegic-neuropathy
#19
Cleo Huang, Maria Amasanti, Ben Lovell, Tim Young
Recurrent painful ophthalmologic neuropathy (RPON), previously termed ophthalmoplegic migraine, is characterised by repeated attacks of one or more ocular cranial nerve palsies with ipsilateral headache. Its cause remains unclear; it is currently thought to be neuropathic in origin, but there is debate in the literature. In documented cases, a third cranial nerve palsy is by far the most common. Here we present a case of RPON involveing the fourth and sixth cranial nervesonly. Thorough investigation, including MR scan of brain and lumbar puncture, found no alternative explanation...
August 2017: Practical Neurology
https://www.readbyqxmd.com/read/28432112/reduction-of-severe-visual-loss-and-complications-following-intra-arterial-chemotherapy-iac-for-refractory-retinoblastoma
#20
M Ashwin Reddy, Zishan Naeem, Catriona Duncan, Fergus Robertson, Jane Herod, Adam Rennie, Alki Liasis, Dorothy Ann Thompson, Mandeep Sagoo
BACKGROUND: Intra-arterial chemotherapy (IAC) for retinoblastoma has been documented as causing visual loss and ocular motility problems. A lack of safety data has precluded its acceptance in all centres. METHODS: Retrospective cohort study of patients with retinoblastoma from 2013 to 2015 who had a healthy foveola and relapsed following systemic chemotherapy. All required IAC. The correlation of complications with doses of melphalan +/- topotecan used and putative catheterisation complications was assessed...
April 21, 2017: British Journal of Ophthalmology
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