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Sixth nerve palsy

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
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
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
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...
August 18, 2016: Journal of Pediatric Ophthalmology and Strabismus
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
Natsuyo Yoshida-Hata, Naomichi Katai, Toshiyuki Oshitari
Purpose. To report the ocular findings in patients with hematopoietic malignancy with optic nerve involvement and abducens nerve palsy. Methods. The medical records of all cases of hematopoietic cancer with ophthalmic involvements seen in the Department of Ophthalmology of the National Center for Global Health and Medicine between 2009 and 2014 were reviewed. Results. Eight patients with hematopoietic cancer with optic nerve invasion or abducens nerve palsy were studied. The primary diseases were 3 cases of multiple myeloma, 1 case of acute lymphocytic leukemia, 1 case of follicular lymphoma, and 3 cases of AIDS-related lymphoma...
2016: Case Reports in Ophthalmological Medicine
B Wabbels
Botulinum toxin can be a useful tool for treating acute sixth nerve palsy and excessive eye deviations due to unstable Graves' disease, when surgery is not yet possible. The diagnostic injection for estimation of possible postoperative double vision also makes sense. In convergence spasms, periocular botulinum toxin injections can be a therapeutic option. Botulinum toxin is not a first line option in infantile esotropia without binocularity or in adult horizontal strabismus. Side effects include ptosis and vertical deviations...
July 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Matthew L Carlson, Brendan P O'Connell, Joseph T Breen, Cameron C Wick, Colin L Driscoll, David S Haynes, Reid C Thompson, Brandon Isaacson, Paul W Gidley, J Walter Kutz, Jamie J Van Gompel, George B Wanna, Shaan M Raza, Franco DeMonte, Samuel L Barnett, Michael J Link
OBJECTIVE: To analyze clinical outcomes after treatment of petroclival chondrosarcoma and to propose a novel staging system. STUDY DESIGN: Retrospective case review, 1995 to 2015. SETTING: Multicenter study. PATIENTS: Consecutive patients with histopathologically proven petroclival chondrosarcoma. INTERVENTION(S): Microsurgery, endoscopic endonasal surgery, radiation therapy, observation. MAIN OUTCOME MEASURES: Disease- and treatment-associated morbidity, recurrence, mortality...
August 2016: Otology & Neurotology
Preeti Patil-Chhablani, Sowmya Murthy, Meenakshi Swaminathan
BACKGROUND: Facial nerve palsy (FNP) occurs less frequently in children as compared to adults but most cases are secondary to an identifiable cause. These children may have a variety of ocular and systemic features associated with the palsy and need detailed ophthalmic and systemic evaluation. METHODS: This was a retrospective chart review of all the cases of FNP below the age of 16 years, presenting to a tertiary ophthalmic hospital over the period of 9 years, from January 2000 to December 2008...
December 2015: Eye Science
Aline Lariessy Campos Paiva, Guilherme Brasileiro de Aguiar, Vinicius Riccieri Ferraz, João Luiz Vitorino Araújo, Milton Hikaro Toita, José Carlos Esteves Veiga
Traumatic brain injury (TBI) is less common in children than in adults. Posterior fossa lesions are even more uncommon, but, when present, are usually epidural hematomas. These lesions, even when small, may have a bad outcome because of the possibility of compression of the important structures that the infratentorial compartment contains, such as the brainstem and cranial nerves, and the constriction of the fourth ventricle, causing acute hydrocephalus. Although unusual, posterior fossa lesions are increasingly being diagnosed because of the better quality of and easier access to cranial tomography...
2016: Pediatric Neurosurgery
Alberto Gálvez-Ruiz, Patrik Schatz
BACKGROUND: Vascular risk factors are increasing rapidly in the Middle East. Growing inactivity and obesity have contributed to an epidemic of Type 2 diabetes mellitus (DM) in the Arab population. Microvascular palsies of the third, fourth, and sixth cranial nerves, which occur in an isolated manner, are relatively common in patients with DM, hypertension, or other vascular risk factors. METHODS: In this retrospective analysis, patients with diabetes with microvascular palsies were assessed for the prevalence of diabetic retinopathy (DR)...
June 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Dragoş Cătălin Jianu, Silviana Nina Jianu, Traian Flavius Dan, Andrei Gheorghe Marius Motoc, Mărioara Poenaru
The emissary veins, like the petrosquamosal sinus (PSS), are residual valveless veins, which connect the intracranial dural venous sinuses and the extracranial venous system. Rarely, they may cause pulsatile tinnitus (PT). A 22-year-old woman developed in the first week of puerperium worsening headaches, vomiting, and diplopia, and the accentuation of a PT in the left ear that she presented for eight years. The clinical examination findings nine days after delivery were unremarkable, with the exception of a left sixth nerve palsy, and a peculiar sensibility of the left temporo-mandibular joint...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Virginie G S Ninclaus, Sophie Walraedt, Edward Baert, Geneviève Laureys, Bart P Leroy, Julie De Zaeytijd
PURPOSE: To describe a patient with diplopia who was diagnosed with Turcot syndrome. METHODS: A 10-year-old boy presented with a history of left-sided sixth and seventh nerve palsy. He underwent imaging of the brain and colon, a full ophthalmological and genetic work-up. RESULTS: A 10-year-old boy was referred with combined left-sided sixth and seventh nerve palsy since 1 month without symptoms of raised intracranial pressure. BCVA was 6/6 in both eyes...
May 3, 2016: International Ophthalmology
M Wipf, A Palmowski-Wolfe
BACKGROUND/PURPOSE: There are no concrete guidelines for the therapeutic use of botulinum toxin in strabismus. The 2012 Cochrane Analysis concluded that it was controversial, but included only 4 prospective randomized controlled trials. However, many retrospective studies suggest that botulinum toxin treatment is a viable alternative to surgical treatment. We have now retrospectively evaluated the outcomes of our patients treated with botulinum toxin. PATIENTS AND METHODS: We retrospectively reviewed the charts of the patients treated with Botox® for strabismus...
April 2016: Klinische Monatsblätter Für Augenheilkunde
Glenmore Lasam, Sakshi Kapur
We report a case of a 50-year-old female with diabetes mellitus who presented with progressive second, third, fifth, sixth, and eighth cranial nerve palsy. Diagnostic investigation revealed hyperglycemic state, and brain imaging showed a right cavernous sinus enhancement suggestive of and consistent with Tolosa-Hunt syndrome. The patient was started on steroids with tight glycemic control for eight weeks; subsequently, the cranial nerve palsies resolved as well as documented resolution of the right cavernous sinus enhancement...
2016: Case Reports in Medicine
J Anna Kim, Federico G Velez, Stacy L Pineles
BACKGROUND: Ocular neuromyotonia (ONM) is a rare motility disorder in which paroxysms of tonic extraocular muscle contraction from abnormal ocular motor nerve firing result in episodic diplopia and strabismus. Medical therapy with membrane-stabilizing agents has varied success. A surgical approach to treatment has not yet been described. We report the outcomes of strabismus surgery in patients with ONM. METHODS: We describe 3 patients with sixth nerve paresis and ONM of the affected lateral rectus muscle who underwent strabismus surgery...
September 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Pernille Vita Fooken Jensen, Michael Stormly Hansen, Martin Nue Møller, Jon Peiter Saunte
BACKGROUND: Gradenigo's Syndrome (GS) is defined as the clinical triad of acute otitis media, ipsilateral sixth nerve palsy, and pain in the distribution of the first and the second branches of the fifth nerve. The purpose of this study is to review the literature and report 4 cases of GS. METHODS: The study is a retrospective case series and a review of the literature. Four consecutive patients (aged 5-70 years) treated by otolaryngologists and ophthalmologists for GS in the Capital region of Denmark from 2003 to 2015 are presented...
2016: Strabismus
Talita Castro, Adriana O L Ortega, Maria Carolina Mussi, Mariana M Braga, Marina Gallottini
PURPOSE: Moebius syndrome (MS) is a rare congenital facial diplegia characterized by partial or complete sixth and seventh cranial nerve palsy. Orofacial manifestations include micrognathia, increased overbite, high arched palate, morphological changes in the tongue, and dental crowding. Case reports and small case series have shown a high prevalence of caries in MS patients. The purpose of this study was to compare the prevalence of caries between individuals with Moebius syndrome and controls using the International Caries Detection and Assessment System (ICDAS)...
January 2016: Pediatric Dentistry
Chu-Peng Hoi, Yung-Tai Chen, Jong-Ling Fuh, Chun-Pai Yang, Shuu-Jiun Wang
BACKGROUND AND PURPOSE: The aim of this nationwide cohort study was to evaluate whether the occurrence of isolated 3rd, 4th or 6th cranial nerve (CN) palsies is associated with a higher risk of ischemic stroke. METHODS: This study utilized data from Taiwan Longitudinal Health Insurance Database during 1995-2012. Subjects aged 20 years or older who had isolated CN 3/4/6 palsies diagnosed by a neurologist or ophthalmologist between January 2000 and December 2011 were included...
2016: Cerebrovascular Diseases
Byung-Euk Joo, Sang-Ku Park, Kyung-Rae Cho, Doo-Sik Kong, Dae-Won Seo, Kwan Park
OBJECTIVE The aim of this study was to define a new protocol for intraoperative monitoring (IOM) of brainstem auditory evoked potentials (BAEPs) during microvascular decompression (MVD) surgery to treat hemifacial spasm (HFS) and to evaluate the usefulness of this new protocol to prevent hearing impairment. METHODS To define the optimal stimulation rate, estimate the number of trials to be averaged, and identify useful warning criteria in IOM of BAEPs, the authors performed a preliminary study of 13 patients with HFS in 2010...
January 29, 2016: Journal of Neurosurgery
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