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Sixth nerve palsy

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https://www.readbyqxmd.com/read/28210639/an-interesting-case-of-tolosa-hunt-syndrome-in-a-young-male
#1
Ghulam Murtaza, Nicholas Konowitz, Hannah Lu, Anadil Faqah, Aneesh Kuruvilla
Tolosa-Hunt syndrome is a rare disease with a limited number of cases reported in the literature. It typically presents with orbital pain associated with palsy of the third, fourth, or sixth cranial nerve. We present an interesting case of Tolosa-Hunt syndrome in a young male who responded well to high-dose steroids and in a few days had significant improvement in his retro-orbital pain and ocular movements.
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28210514/hemorrhagic-colloid-cyst-presenting-with-acute-hydrocephaly
#2
Reza Akhavan, Behrouz Zandi, Masoud Pezeshki-Rad, Donya Farrokh, Bita Abbasi
Colloid cysts are benign slow-growing cystic lesions located on the roof of the third ventricle that usually present with symptoms related to gradual rise of intracranial pressure. They mostly remain asymptomatic and sometimes grow progressively and cause diverse symptoms associated with increased intracranial pressure such as headache, diplopia, and sixth cranial nerve palsy. Here we report a 47-year-old female who presented to the emergency department with acute severe headache and nausea/vomiting. On MRI examination acute hydrocephaly due to hemorrhagic colloid cyst was detected...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28182149/anterior-segment-ischemia-after-strabismus-surgery
#3
Emine Seyhan Göçmen, Yonca Atalay, Özlem Evren Kemer, Hikmet Yavuz Sarıkatipoğlu
A 46-year-old male patient was referred to our clinic with complaints of diplopia and esotropia in his right eye that developed after a car accident. The patient had right esotropia in primary position and abduction of the right eye was totally limited. Primary deviation was over 40 prism diopters at near and distance. The patient was diagnosed with sixth nerve palsy and 18 months after trauma, he underwent right medial rectus muscle recession. Ten months after the first operation, full-thickness tendon transposition of the superior and inferior rectus muscles (with Foster suture) was performed...
January 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28043726/an-unusual-cause-of-unilateral-sixth-nerve-palsy
#4
Mehran Sotoodehnia, Arash Safaei, Fatemeh Rasooli, Maryam Bahreini
BACKGROUND: The diagnosis of cerebral venous sinus thrombosis still remains a real challenge. Seizure, unusual headache with sudden onset, unexplained persistently unilateral vascular headache and neurologic deficit-which is difficult to be attributed to a vascular territory are some of the suggestive symptoms. CASE: An isolated sixth nerve palsy is discussed as a rare presentation for cerebral venous thrombosis. Following the extensive investigation to rule out other possible diagnoses, magnetic resonance venogram revealed the final etiology of sixth nerve palsy that was ipsilateral left transverse sinus thrombosis; therefore, anticoagulant treatment with low molecular weight heparin was administered...
December 12, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28009406/the-frequency-and-causes-of-abnormal-head-position-based-on-an-ophthalmology-clinic-s-findings-is-it-overlooked
#5
Kadriye Erkan Turan, Hande Taylan Sekeroglu, Irem Koc, Meltem Kilic, Ali S Sanac
PURPOSE: To determine the frequency of abnormal head position (AHP) and identify the underlying causes in patients who presented to an ophthalmology clinic due to any ophthalmologic complaint. METHODS: The medical records of patients who presented with any ophthalmologic symptoms during a 6-month period were prospectively evaluated. In all, 2,710 patients (1,492 female and 1,218 male) aged 6 months-91 years were included in the study. Each patient underwent complete ophthalmologic evaluation...
December 2, 2016: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/27966268/ophthalmological-findings-in-children-with-encephalitis
#6
Kerstin Hellgren, Åsa Fowler, Agneta Rydberg, Ronny Wickström
PURPOSE: To evaluate ophthalmological abnormalities in children with acute encephalitis. METHODS: Thirty-six children included in a hospital-based prospectively and consecutively collected cohort of children with acute encephalitis were investigated for ophthalmological abnormalities. The investigation included clinical ophthalmological examination, fundus photography, neuro-ophthalmological examinations as well as visual and stereo acuity. Results on laboratory examinations, clinical findings, neuroimaging and electroencephalography registrations were recorded for all children...
February 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/27965263/primary-intravenous-chemotherapy-for-group-d-retinoblastoma-a-13-year-retrospective-analysis
#7
Ido D Fabian, Andrew W Stacey, Kenneth P Johnson, Zerrin Onadim, Tanzina Chowdhury, Catriona Duncan, M Ashwin Reddy, Mandeep S Sagoo
BACKGROUND: Eye salvage rate for group D retinoblastoma using intravenous chemotherapy (IVC) as a primary modality is <50%. To report on 13 years' experience with the use of primary IVC for group D retinoblastoma. METHODS: A retrospective analysis of 64 group D eyes (52 patients) treated with primary IVC, from 2002 to 2014. RESULTS: The median age at presentation was 11.0 months (mean: 18.6, range: 0.6-144.0), 35 (67%) patients had bilateral disease, 38 (73%) germline disease and 8 (15%) cases were familial...
January 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/27928392/metastatic-papillary-thyroid-carcinoma-presenting-as-abducens-palsy-complicated-by-ocular-neuromyotonia
#8
Niloofar Yari, Angelina Espino Barros Palau, Michael L Morgan, Nicholas B Levine, Andrew G Lee
Papillary thyroid carcinoma (PTC) is a type of well-differentiated thyroid cancer that accounts for the majority of thyroid malignancies. The prognosis of PTC is very good and distant metastases are rare, especially to the skull base. The authors report the case of a 47-year-old woman with biopsy-proven PTC treated with surgery and radiation therapy who presented with headache and diplopia after 5 years and was found to have clivus and cavernous sinus metastasis. Following radiation therapy for her skull base and cavernous sinus lesion, she subsequently developed sixth nerve ocular neuromyotonia...
April 2016: Neuro-ophthalmology
https://www.readbyqxmd.com/read/27928378/sixth-nerve-palsy-in-paediatric-intracranial-hypertension
#9
Julia E Reid, Rachel E Reem, Shawn C Aylward, David L Rogers
The purpose of this study was to report the incidence and describe the characteristics of sixth cranial nerve (CN VI) palsy in paediatric patients with intracranial hypertension (IH). A retrospective chart review of central Ohio children diagnosed with IH over the 3-year period from 2010 to 2013 was conducted. IH without identifiable cause was defined as idiopathic intracranial hypertension (IIH), whereas IH with identifiable pathologic aetiology was deemed secondary intracranial hypertension (SIH). A subset of patients with CN VI palsy was identified...
February 2016: Neuro-ophthalmology
https://www.readbyqxmd.com/read/27917763/a-case-of-convergence-spasms-do-not-be-caught-off-guard
#10
L Smit
A hypertensive patient presented with complaints of headache and fluctuating double vision and deterioration in vision from 2010. She displayed symptoms associated with convergence spasms, which could be confused with sixth cranial nerve palsies. A few pointers are given to prevent clinicians from being caught off-guard when encountering this clinical condition.
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27857798/not-all-cases-of-nyctalopia-are-benign-unusual-and-serendipitous-presentation-of-arnold-chiari-type-1-malformation-at-a-pediatric-tertiary-care-center
#11
Kailash Chandra Patra, Abhijeet Prakash Kirtane
The Arnold-Chiari Type 1 malformation (CM1) is a rare congenital abnormality characterized by ectopia or caudal herniation of the cerebellar tonsils through the foramen magnum into the cervical spine, resulting in crowding at the craniocervical junction. It seldom presents in childhood with symptoms and a normal neurological examination. More typically, CM1 presents in young adult women with neurological symptoms including a headache, cervical pain, cranial nerve palsies, neurosensory deficit, and ataxia. Ocular manifestations associated with Chiari I include third and sixth cranial nerve paresis and convergence/divergence abnormalities...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27847774/fusiform-superior-cerebellar-artery-aneurysm-treated-with-endovascular-treatment
#12
Joon Bok Jeon, Se-Yang Oh, Dong-Keun Hyun, Yu Shik Shim
An aneurysm of the distal superior cerebellar artery (SCA) is a highly rare disease. Fusiform aneurysms of the distal SCA are particularly challenging to treat. Clipping, trapping with or without bypass using microsurgery or endovascular treatment (EVT) were used to treat this condition. We describe the case of fusiform distal SCA aneurysms treated successfully with endovascular coiling with a 3-month follow-up. A 39 year-old male was presented with subarachnoid hemorrhage (SAH) and a 15 mm fusiform aneurysm of the ambient segment of the left distal SCA...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27846186/ocular-motor-palsy-after-spinal-puncture
#13
Monica Del-Rio-Vellosillo, José J Garcia-Medina, Maria Dolores Pinazo-Duran, Antonio Abengochea-Cotaina, Manuel Barbera-Alacreu
Ocular motor palsy is a rare but alarming complication of subarachnoid puncture. In order to better understand this condition, a literature search was performed in English of PubMed articles for cranial nerves III, IV, and VI palsies after spinal puncture. Sixty-five articles (dated 1930-2015) were identified, and 114 cases were obtained for analysis. Subarachnoid anesthesia was the most frequent cause (45.6%), with a higher incidence for females than males. The age of patients was 40.24 ± 13.35 years (age range, 6-71 years)...
January 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27819416/neurological-manifestations-of-acute-posterior-multifocal-placoid-pigment-epitheliopathy
#14
Hussein Algahtani, Ashjan Alkhotani, Bader Shirah
BACKGROUND AND PURPOSE: Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an immune-mediated chorioretinal disease that causes acute visual symptoms with characteristic ophthalmoscopic findings. Neurological complications are rarely reported in the literature. Here we report two new cases of APMPPE that presented with neurological manifestations, one of which was associated with peripheral neuropathy, which has not been described before. METHODS: A retrospective database review of all patients with a diagnosis of APMPPE was performed...
October 2016: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/27813529/augmented-vertical-recti-transposition-with-intraoperative-botulinum-toxin-for-complete-and-chronic-sixth-nerve-palsy
#15
R Nabie, D Andalib
PurposeTo evaluate the results of augmented vertical rectus muscle transposition (VRT) with intraoperative botulinum toxin (BTX) for complete and chronic sixth nerve palsy.MethodsDuring a 10-year period (2004-2014) all patients with chronic and complete sixth nerve palsy and contracted medial rectus (MR) who underwent augmented VRT and BTX injection into the MR enrolled in this study.ResultsIn total, 29 patients (5 bilateral) were enrolled in this study. Preoperative deviation was 45±17.5 Prism Diopter (PD), which was improved to -3...
January 2017: Eye
https://www.readbyqxmd.com/read/27782818/bilateral-abducens-nerve-palsy-in-an-infant-case-of-fulminant-acute-disseminated-encephalomyelitis-a-case-report
#16
Zhiliang Yang, Guilian Sun
BACKGROUND: Sixth (abducens) nerve palsy (ANP) is far less frequent in children and has not been reported as a sign of acute disseminated encephalomyelitis (ADEM). We present an infant case of ADEM with bilateral abducens nerve palsy (BANP). CASE PRESENTATION: We report one case of BANP in a 15-month-old boy of fulminant ADEM. The patient underwent physical examinations and brain MRI scan three times during about six months follow-up. The patient had BANP and developmental regression when he regained consciousness from a coma, and the signs had persisted for 6-months...
October 26, 2016: BMC Ophthalmology
https://www.readbyqxmd.com/read/27686096/efficacy-of-low-dose-corticosteroid-therapy-versus-high-dose-corticosteroid-therapy-in-bell-s-palsy-in-children
#17
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
https://www.readbyqxmd.com/read/27558865/sixth-nerve-palsy-following-botulinum-toxin-injection-for-facial-rejuvenation
#18
Ayse Dolar Bilge, Fariz Sadigov, Senem Salar-Gomceli
BACKGROUND: Botulinum toxin A (BTX) has been widely used for a variety of facial esthetic procedures within the last couple of decades. Efficacy and safety of BTX for facial rejuvenation has been extensively studied in multiple randomized prospective controlled trials. Focal weakness is among the most commonly reported adverse effects. Adverse reactions tend to occur most commonly due to errors in dosing formulation and errors with the techniques of the application. No serious long-term complications have been reported...
September 26, 2016: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/27542602/isolated-diplopia-associated-with-calcineurin-inhibitor-therapy-in-a-patient-with-idiopathic-membranous-nephropathy-a-case-report
#19
Ashwani K Gupta, Nader Bahri
BACKGROUND: Neurotoxicity is a common side effect of treatment with calcineurin inhibitors. Tremors are frequently reported as the most common manifestation. Variable presentations can include headaches, seizures, visual hallucinations or blindness. Sixth nerve palsy has been reported in previous cases of bone marrow and cardiac transplant patients receiving calcineurin inhibitors. In many of these previously reported cases, the drug was administered intravenously and very high drug levels were found...
2016: BMC Nephrology
https://www.readbyqxmd.com/read/27537250/double-augmented-vertical-rectus-transposition-for-large-angle-esotropia-due-to-sixth-nerve-palsy
#20
Priyanka Singh, Perumalsamy Vijayalakshmi, Shashikant Shetty, Priyanka Vora, Suresh Kalwaniya
PURPOSE: To study the binocular alignment and ocular motility in patients with large-angle esotropia due to sixth nerve palsy treated with double augmented vertical recti transposition. METHODS: This was a prospective interventional study. Fifteen patients with non-resolving sixth nerve palsy who underwent surgical correction were included in the study. Fourteen patients also underwent an additional medial rectus recession. Two patients with an associated small vertical deviation had a selective augmentation of one vertical rectus muscle...
November 1, 2016: Journal of Pediatric Ophthalmology and Strabismus
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