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Diabetic ophthalmoplegia

Carl Erb, Katarzyna Konieczka
Mitochondrial function is closely linked to numerous aspects of eye health. Imbalance between the creation of energy and the development of reactive oxygen species (ROS) seems to be the cause of the development of mitochondrial dysfunctions. As a result of this energy deficit, the level of oxidative stress in the eye tissues increases, leading to numerous ophthalmic impairments. It is important to distinguish between primary mitochondrial eye diseases and secondary mitochondrial changes. Primary mitochondrial eye diseases, for example Leber's hereditary optic atrophy (LHON), retinitis pigmentosa and chronic progressive external ophthalmoplegia are caused by direct damage to mitochondrial function induced by defective genes, either located on mitochondrial DNA (mtDNA) or the DNA of the nucleus (nDNA)...
February 2018: Klinische Monatsblätter Für Augenheilkunde
Guillaume Lamotte, Zehra Farzal, William Denney Zimmerman, Suhua Han, Pedro de Brito, Douglas Mayson
No abstract text is available yet for this article.
December 12, 2017: Neurology
Yun Zhang, Lili Wang, Maolin He
The clinical features and pathogenesis of the pure midbrain infarction need to be described. Of 4257 stroke patients who were on the stroke registry between January 2000 and December 2015, 25 patients with pure midbrain infarctions, as demonstrated on diffusion-weighted magnetic resonance imaging, were enrolled. We analyzed the clinical features, MRI findings, and etiologic mechanisms of the infarctions. According to the distribution of each penetrating artery of the midbrain, we classified all the infarctions into paramedian (PM) area (13 patients), lateral area (10 patients), and PM and lateral areas (2 patients)...
November 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Saman Zafar, Aparna Prabhu
A 22-year-old woman presented with diabetic ketoacidosis, acute right eye blindness and complete ophthalmoplegia. Despite early suspicion and treatment for rhino-orbito-cerebral mucormycosis, her extensive spread of infection led to right internal carotid artery occlusion and cavernous sinus thrombosis, right-sided cerebral watershed infarctions and large abscesses in her right cerebellum, temporal lobe and pons. She underwent surgical removal of her right eye, paranasal sinuses, maxilla and palate, suboccipital craniectomy and shunting for hydrocephalus...
December 2017: Practical Neurology
Efstratios-Stylianos Pyrgelis, Ioannis Mavridis, Maria Meliou
The classical term "pituitary apoplexy" (PA) describes a clinical syndrome usually characterized by abrupt onset of headache accompanied by neurologic and/or endocrinologic deterioration due to sudden expansion of a mass within the sella turcica as a result of hemorrhage or infarction within a pituitary tumor and adjacent pituitary gland. PA is a medical emergency and a difficult diagnosis to establish. Thus this article reviews the presenting symptoms of PA patients to help clinicians recognize or at least suspect this critical condition early on...
January 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
J Langrand-Escure, A Vallard, J-Ph Suchaud, P Diao, N Magné
Pituitary metastasis occur in 1-5 % of patients with cancer. We report the discovery of a unique pituitary metastasis of breast cancer. A 67 years old woman was treated in 2003 for local adenocarcinoma. After bone metastatic relapse in 2008, the patient developed diplopia and diabetes insipidus. An MRI revealed a histologically proven metastatic pituitary nodule. Further explorations revealed failure of multiple endocrine axes. Pituitary metastases are relatively rare, but are probably under-diagnosed in the presence of advanced cancers with impaired general condition...
July 2016: Revue Médicale de Liège
Tomohiro Ota, Mineo Yamazaki, Yusuke Toda, Akiko Ozawa, Kazumi Kimura
A 66-year-old man presented with headache and ophthalmalgia. Diplopia developed, and he was hospitalized. The left eye had abducent paralysis and proptosis. We diagnosed him with Tolosa-Hunt syndrome and administered methylprednisolone at 1 g/day for 3 days. However, the patient did not respond to treatment. No abnormality was found on his MRI or cerebrospinal fluid examination. Tests showed his serum immunoglobulin G4 and antineutrophil cytoplasmic antibody titers were within normal limits. He also had untreated diabetes mellitus (HbA1c 9...
April 28, 2017: Rinshō Shinkeigaku, Clinical Neurology
Roberto Spina, Neil Simon, Romesh Markus, David W M Muller, Krishna Kathir
Contrast-induced encephalopathy (CIE) is an acute and reversible neurological disturbance associated with the intra-arterial administration of iodinated contrast medium during cardiac catheterisation. It may manifest with encephalopathy, motor and sensory disturbances; vision disturbances, including cortical blindness, ophthalmoplegia, aphasia; and seizures. Disruption of the blood-brain barrier and direct neuronal toxicity are believed to be implicated in the pathophysiology of the syndrome. Symptoms appear soon after contrast administration and resolve completely within 24-48 h...
February 2017: Internal Medicine Journal
Hideaki Kawakami, Kiyofumi Mochizuki, Kyoko Ishida, Kiyofumi Ohkusu
PURPOSE: To describe the clinical manifestations and prognoses in 7 patients with invasive sino-orbital aspergillosis (ISOA). METHODS: This was a retrospective study of consecutive patients who were diagnosed as having ISOA at the Gifu University Hospital and Gifu Municipal Hospital between January 1993 and December 2015. Data were collected on demographics, initial manifestations, examination findings, treatments, clinical course, and outcomes. RESULTS: The median age of the 7 patients with ISOA was 68 years; 5 of them had diabetes...
March 2017: Japanese Journal of Ophthalmology
Khairuddin Othman, Li Min Evelyn-Tai, Mohd Noor Raja-Azmi, Muhammed Julieana, Ahmad Tajudin Liza-Sharmini, John Tharakan, Alwi Muhd Besari, Embong Zunaina, Ismail Shatriah
INTRODUCTION: Hyphema and orbital apex syndrome occurring concurrently in a patient with herpes zoster ophthalmicus have not been reported previously. We present a case with these unique findings and discuss the pathogenesis of these conditions and their management. PRESENTATION OF CASE: A 59-year-old Malay lady with underlying diabetes mellitus presented with manifestations of zoster ophthalmicus in the left eye. Two weeks later, she developed total hyphema, and complete ophthalmoplegia suggestive of orbital apex syndrome...
2017: International Journal of Surgery Case Reports
Amy Armstrong-Javors, Janey Pratt, Sigmund Kharasch
Roughly 1% of all weight loss surgery is performed in adolescents. There is strong evidence demonstrating significant postsurgical weight loss, improvement in quality of life, and reduction in comorbidities such as hypertension and diabetes. Reports of postoperative complications in adolescents are few because of the small sample size in most series. Despite vitamin supplementation, nutritional deficiencies requiring hospitalization occur occasionally after Roux-en-Y gastric bypass. Wernicke encephalopathy, a triad of ophthalmoplegia, ataxia, and altered mental status, is a serious consequence of thiamine (vitamin B1) deficiency...
December 2016: Pediatrics
Janez Ravnik, Tomaz Smigoc, Gorazd Bunc, Bostjan Lanisnik, Ursa Ksela, Maja Ravnik, Tomaz Velnar
Metastatic tumours to the pituitary gland are rare. The most frequent are metastases from breast and lung. We describe three patients with metastatic tumours: (I) a 54-year-old patient with metastatic renal clear-cell carcinoma and consequent disturbances in visual acuity, cranial nerve paresis and panhypopituitarism, (II) a 60-year-old patient with a diffuse large B-cell lymphoma with panhypopituitarism and diabetes insipidus and (III) a 57-year-old patient with metastasis of breast cancer and panhypopituitarism, visual impairment and cranial nerve paresis...
November 2016: Neurologia i Neurochirurgia Polska
Eman S Al Kahtani, Rajiv Khandekar, Khalid Al-Rubeaan, Amira M Youssef, Heba M Ibrahim, Ahmed H Al-Sharqawi
BACKGROUND: There are limited data on the epidemiology and risk factors of ophthalmoplegia among diabetic patients. This study aims to determine the prevalence and important risk factors related to ophthalmoplegia among diabetic patients. METHODS: This is an observational registry-based study using the Saudi National Diabetes Registry (SNDR) database to select diabetic patients regardless of their diabetes type. A total of 64,351 Saudi diabetic patients aged more than 18 years and registered in SNDR between January 2000 and December 2010 were analyzed to identify ophthalmoplegic cases...
July 22, 2016: BMC Ophthalmology
Mehdi Bakhshaee, Amin Bojdi, Abolghasem Allahyari, Mohammad Reza Majidi, Sherwin Tavakol, Mohammad Javad Najafzadeh, Masoud Asghari
Acute invasive fungal rhinosinusitis (AIFRS) is a rapidly progressive life threatening infection that is seen most commonly among immunocompromised patients. We present a case series of 18 patients clinically and histopathologically diagnosed with AIFRS with a mean follow-up of 9.11 ± 2.51 months (range 6-17). Demographic data, apparent symptoms and signs, underlying disorders, and outcomes are discussed. The mean age was 39.56 ± 20.66 years (range 2-75). The most common underlying diseases were diabetes mellitus (50 %) and leukemia (44...
December 2016: European Archives of Oto-rhino-laryngology
Ramzi Mulki, Muhammad Masab, Glenn Eiger, Sarah Perloff
Rhinocerebral mucormycosis (RCM) is an angioinvasive fungal infection most often caused by Rhizopus oryzae It is usually associated with an underlying risk factor and is associated with a poor prognosis. There are no consensus guidelines on the optimal management of this aggressive disease; most management decisions are based on case reports and expert opinion. We report a successfully managed case of RCM in an insulin-dependent diabetic, initially presenting with a change in mental status, rapidly progressing to complete right eye blindness and ophthalmoplegia and complicated by multiple cerebral infarctions and abscesses...
June 2, 2016: BMJ Case Reports
Francesco Pellegrini, Giovanni Prosdocimo, Jason J S Barton
A 56-year-old man with diabetes presented with acute diplopia and signs of bilateral complete abduction deficits. Diffuse areflexia was his only other sign at presentation. Within a few days, he developed complete ophthalmoplegia and ataxia, consistent with a clinical diagnosis of Miller-Fisher syndrome, and repeated history revealed a possible gastroenteritis 3 weeks prior. This case illustrates an "ophthalmoplegia without ataxia" variant of this classic autoimmune condition, which should be considered in patients presenting with bilateral VI nerve palsies...
March 2016: Survey of Ophthalmology
Yuan Li, Bo Zheng, Kangning Chen, Li Gui
Two patients developed cavernous sinus thrombophlebitis from a tooth infection. A 36-year-old man experienced a severe headache with bilateral third and sixth cranial nerve palsies after extraction of his left upper third molar. Another 53-year-old diabetic man developed fever, headache, and bilateral complete ophthalmoplegia after a tooth infection. The brain magnetic resonance imaging scans of both patients showed bilateral cavernous sinus partial thrombosis. Broad-spectrum antibiotics plus low-molecular-weight heparin successfully resolved all symptoms...
August 2015: Journal of Oral and Maxillofacial Surgery
Asim V Farooq, Rakesh M Patel, Amy Y Lin, Pete Setabutr, Juliana Sartori, Vinay K Aakalu
PURPOSE: To report a series of patients with fungal orbital cellulitis who underwent exenteration surgery and describe presenting features, management and outcomes at a referral center. METHODS: Retrospective case series. RESULTS: From November 2011 to March 2014, four patients underwent orbital exenteration for fungal orbital cellulitis at the University of Illinois. Three patients had mucormycosis and one had aspergillosis. All patients were treated with intravenous antifungals and underwent orbital exenteration...
June 2015: Orbit
Jackson A Gondim, João Paulo Almeida, Lucas Alverne F de Albuquerque, Erika Gomes, Michele Schops, Jose Italo Mota
OBJECT: With the increase in the average life expectancy, medical care of elderly patients with symptomatic pituitary adenoma (PA) will continue to grow. Little information exists in the literature about the surgical treatment of these patients. The aim of this study was to present the results of a single pituitary center in the surgical treatment of PAs in patients > 70 years of age. METHODS: In this retrospective study, 55 consecutive elderly patients (age ≥ 70 years) with nonfunctioning PAs underwent endoscopic transsphenoidal surgery at the General Hospital of Fortaleza, Brazil, between May 2000 and December 2012...
July 2015: Journal of Neurosurgery
Carmela Scuderi, Eugenia Borgione, Filippa Castello, Mariangela Lo Giudice, Sandro Santa Paola, Mariaconcetta Giambirtone, Francesco Domenico Di Blasi, Maurizio Elia, Carmelo Amato, Santina Città, Catalda Gagliano, Giuliano Barbarino, Girolamo Aurelio Vitello, Sebastiano Antonino Musumeci
Mutations in the polymerase gamma-1 (POLG1) gene, encoding the catalytic subunit of the mtDNA-specific polymerase-γ, compromise the stability of mitochondrial DNA (mtDNA) and are responsible for numerous clinical presentations as autosomal dominant or recessive progressive external ophthalmoplegia (PEO), sensory ataxia, neuropathy, dysarthria and ophthalmoparesis (SANDO), spinocerebellar ataxia with epilepsy (SCAE) and Alpers syndrome. POLG1 mutations result in extremely heterogeneous phenotypes which often have overlapping clinical findings, making it difficult to categorize patients into syndromes, and genotype-phenotype correlations are still unclear...
April 2015: Neuromuscular Disorders: NMD
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