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Brain Behav 2021 Jun 21. Epub 2021 Jun 21.

Department of Neurology, Liaocheng People's Hospital, Liaocheng, Shandong, P.R. China.

Background: A long debate has been going on in the clinical effectiveness to determine whether surgical clipping or coiling more favorable for oculomotor nerve palsy (ONP) caused by PcomAA. We aimed to perform a study, focusing on the effectiveness of ONP induced by PcomAA after treatment of surgical clipping and endovascular coiling.

Method: Potential studies were searched on PubMed, EMBASE, Web of Science, and Cochrane Library from database inception to February 2021, and STATA version 12. Read More

Am J Transl Res 2021 15;13(5):5679-5684. Epub 2021 May 15.

Department of Neurosurgery, Wuhan Puren Hospital, Wuhan University of Science and Technology Wuhan, China.

Objective: To explore the clinical effect of the surgical clipping and endovascular embolization for senile patients with posterior communicating artery aneurysms (PComA) complicated with oculomotor nerve palsy (ONP) and their neurological recovery.

Methods: A total of 96 senile patients with PComA complicated with ONP admitted to our hospital from May 2018 to May 2019 were selected and assigned into the experimental group and the control group according to the randomization method, with 48 cases in each group. The patients in the control group underwent surgical clipping, whereas the patients in the experimental group received the endovascular embolization. Read More

World Neurosurg 2021 Jun 14. Epub 2021 Jun 14.

Department of Neurosurgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata City, Osaka, Japan.

Background: We describe a continuous monitoring method aimed at preserving nerve function during biopsy of lesions on the oculomotor nerve using stimulation of the oculomotor nerve proximal to the lesion.

Case Description: A 5-year-old girl with a recurrent left oculomotor nerve palsy and contrast-enhancing left oculomotor nerve mass on magnetic resonance imaging (MRI), underwent a biopsy of the lesion to aid in its diagnosis. At the time of surgery, needle electrodes were inserted into the superior and inferior rectus muscles percutaneously, and cotton covered electrodes were implanted into the oculomotor nerve proximal to the lesion. Read More

J R Coll Physicians Edinb 2021 06;51(2):143-145

Neurology, University Hospitals Birmingham NHS Foundation Trust, Neurology, UK.

Sinusitis is a common condition, but only very rarely accompanied by isolated cranial nerve palsies. We describe a case of a 64-year-old male with a two-day history of left-sided ptosis associated with one week of nasal congestion and frontal sinus pain. Examination revealed ptosis with left pupil mydriasis. Read More

Eur J Case Rep Intern Med 2021 31;8(5):002616. Epub 2021 May 31.

Department of Surgery, Tokyo Nishi Tokushukai Hospital, Tokyo, Japan.

A 79-year-old woman presented with left retro-orbital pain, headache and blurred vision. Based on negative radiological tests, life-threatening conditions like subarachnoid haemorrhage (SAH) were ruled out and outpatient follow-up was planned. However, the patient returned to the hospital that night because of progressively declining consciousness and was diagnosed with SAH by head computed tomography. Read More

Eur J Case Rep Intern Med 2021 4;8(5):002509. Epub 2021 May 4.

Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy.

Background: Diplopia is the double vision of a single object, and can be binocular or monocular. Binocular diplopia is caused by the misalignment of the visual axes, with images falling on the fovea of the fixating eye and on the extra-foveal retina of the non-fixating eye, as a consequence of both neurological (i.e. Read More

BMJ Case Rep 2021 Jun 10;14(6). Epub 2021 Jun 10.

Stroke Medicine, New Cross Hospital, Wolverhampton, UK.

A man in his early 40s with no significant vascular risk factors was managed within a period of 6 months for recurrent vascular events: ischaemic stroke, transient ischaemic attack and isolated third nerve palsy. He was extensively investigated throughout the course of illness. The only potential aetiological factor identified was a positive janus kinase 2 (JAK 2) mutation after screening on account of mildly elevated platelet count noted during his most recent admission. Read More

Arch Soc Esp Oftalmol (Engl Ed) 2021 Jun 27;96(6):288-292. Epub 2021 Feb 27.

Hospital de San Juan de Dios, Santiago, Chile.

Objective: To establish the success rate of salvage intra-arterial chemotherapy (IAC), defined as the percentage of eyes that achieved tumoral remission and avoided enucleation. The second objective was the clinical characterization, catheterization results, and associated local and systemic complications.

Methods: Retrospective, interventional case series of 29 patients (35 eyes) with persistent or recurrent retinoblastoma. Read More

Medicine (Baltimore) 2021 Jun;100(22):e26242

Department of Neurology.

Rationale: A special case of transient oculomotor nerve palsy after cerebral angiography.

Patient Concerns: A 55-year-old man developed oculomotor nerve dysfunction after right radial artery puncture angiography.

Diagnoses: Cerebral angiography-induced oculomotor nerve palsy. Read More

PLoS One 2021 4;16(6):e0252825. Epub 2021 Jun 4.

Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany.

Introduction: Niemann-Pick type C (NPC) is a lysosomal storage disease that is progressive and life-limiting, with an estimated incidence of 1:120,000 live births. In addition to systemic manifestation with (hepato-)splenomegaly, there are a number of neurological manifestations (ataxia, dysarthria, dementia, cataplexy, epileptic seizures, and psychiatric disorders). Characteristic is vertical supranuclear gaze palsy, which is often overlooked. Read More

Surg Neurol Int 2021 10;12:219. Epub 2021 May 10.

Department of Neurosurgery, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.

Background: Ocular neuromyotonia (ONM) is a rare ocular motility disorder characterized by involuntary paroxysmal extraocular muscle contraction and is caused by radiation therapy, vascular compression, and inflammatory disease. This study includes a rare case of ONM caused by a recurrent meningioma.

Case Description: A 56-year-old man presented with diplopia due to the right oculomotor nerve palsy caused by a sphenoidal atypical meningioma, with improved symptoms after initial surgery. Read More

Clin Neurol Neurosurg 2021 Jul 16;206:106689. Epub 2021 May 16.

Department of Neurosurgery, Hopitaux Robert Schuman, Luxembourg, Luxembourg.

Background: Although the superiority of clipping compared to coiling on the oculomotor nerve palsy (ONP) recovery for ruptured posterior communicating artery aneurysms (PcomAAs) has been widely accepted, which treatment modality is better in the treatment of ONP induced by unruptured PcomAAs still remains unclear.

Methods: A meta-analysis of studies that compared clipping with coiling was performed after a literature search. Perioperative data and clinical outcome were extracted. Read More

BMC Ophthalmol 2021 May 27;21(1):235. Epub 2021 May 27.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 Xianlie Road, Guangzhou, 510060, China.

Purpose And Background: Recently, we found that maximal medial rectus recession and lateral rectus resection in patients with complete lateral rectus paralysis resulted in a partial restoration of abduction. In an attempt to understand some of the mechanisms involved with this effect we examined gene expression profiles of lateral recti from these patients, with our focus being directed to genes related to myogenesis.

Materials And Methods: Lateral recti resected from patients with complete lateral rectus paralysis and those from concomitant esotropia (controls) were collected. Read More

NMC Case Rep J 2021 Apr 2;8(1):89-93. Epub 2021 Apr 2.

Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Fukuoka, Japan.

We describe a rare case of an anterolaterally projecting clinoid segment aneurysm of the internal carotid artery (ICA) causing oculomotor palsy. A 76-year-old woman was referred to our facility because of right oculomotor palsy that had been found just before surgery to remove bilateral cataracts. Neuroimaging revealed that the patient had an aneurysm at the clinoid segment that projected anterolaterally, eroding the anterior clinoid process. Read More

J Neuroophthalmol 2021 Apr 26. Epub 2021 Apr 26.

Department of Ophthalmology, Gold Coast Health (DL, PH, FI), Gold Coast, Australia; and Department of Neurosurgery, Princess Alexandra Hospital (AL), Brisbane, Australia.

Emerg Med Int 2021 23;2021:5550371. Epub 2021 Apr 23.

Department of Neurosurgery, The Royal London Hospital, London E1 1FR, UK.

Third cranial nerve palsy (3cnP) following traumatic brain injury (TBI) is a worrying neurological sign and is often associated with an expanding mass lesion, such as extradural or acute subdural haematomas. Isolated 3cnP can be found in the absence of posttraumatic space-occupying mass lesion, yet it is often considered as a devastating prognostic factor in the context of diffuse axonal injury (DAI). Through the analysis of five exemplificative cases and a thorough review of the literature, we identified four possible mechanisms leading to 3cnP: (1) a partial rootlet avulsion at the site of exit from the midbrain, representing a direct shearing injury to the nerve; (2) a direct traction injury due to the nerve stretching against the posterior petroclinoid ligament at the base of the oculomotor triangle secondary to the downward displacement of the brainstem at the time of impact; (3) a direct vascular compression as a result of internal carotid artery (ICA) dissection or pseudoaneurysm; (4) an indirect injury caused by impaired blood supply to the third nerve in addition to the detrimental biochemical effects of the underlying brain injury itself. Read More

Eur Neurol 2021 May 11:1-8. Epub 2021 May 11.

Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Introduction: Imaging data were scarce on diabetic oculomotor nerve palsy (ONP). Our study explored the MRI features and their clinical implications for diabetic ONP.

Methods: Fifty-nine patients with a clinical diagnosis of diabetic ONP were recruited from our department between January 2015 and December 2019. Read More

Pediatr Neurol 2021 07 2;120:11. Epub 2021 Apr 2.

Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy; Neuroimmunology Group, Paediatric Research Institute Città della Speranza, Padua, Italy; Department of Neurosciences (DNS), University of Padua, Padua, Italy.

Cureus 2021 Apr 3;13(4):e14280. Epub 2021 Apr 3.

Neurology, Jersey Shore University Medical Center, Neptune, USA.

Coronavirus disease 2019 (COVID-19) is known to be primarily a viral infection affecting the pulmonary system leading to severe pneumonia and acute respiratory distress syndrome. COVID-19 has also been found to affect the neurological system causing various nerve palsies. While some studies have suggested these neurological manifestations may indicate severe disease, cranial nerve palsies in the setting of COVID-19 infection have been linked to improved patient outcomes and mild viral symptoms. Read More

BMJ Case Rep 2021 May 6;14(5). Epub 2021 May 6.

Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada

A 49-year-old man presented with new onset headache and diplopia, with right ptosis and limitation of extraocular movements consistent with a third nerve palsy. He had a known diagnosis of a non-functioning pituitary adenoma, and his presentation and neuroimaging were consistent with ischaemic pituitary apoplexy. The patient was otherwise stable with no signs of optic neuropathy or endocrine abnormality. Read More

Klin Monbl Augenheilkd 2021 Apr 30;238(4):474-477. Epub 2021 Apr 30.

Augenklinik, Kantonsspital St. Gallen, Schweiz.

Background: The therapeutic treatment of ocular motility disorders and anomalous head postures (AHP) is often challenging. We report our experience with prism use in these patients.

Patients And Methods: Retrospective case series of three patients with ocular motility disorders and associated AHP who were treated with prism correction. Read More

Klin Monbl Augenheilkd 2021 Apr 30;238(4):499-503. Epub 2021 Apr 30.

Strabologie et ophtalmologie pédiatrique, Université de Lausanne, Hôpital ophtalmique Jules-Gonin, Fondation Asile des aveugles, Lausanne, Schweiz.

Purpose: The rectus inferior myopexy is often used in vertical incomitant deviations without significant deviation in primary position. We analysed the long-term results in different pathologies.

Methods: Retrospective study of patients operated on rectus inferior myopexy between 1984 and 2018. Read More

Klin Monbl Augenheilkd 2021 Apr 30;238(4):493-498. Epub 2021 Apr 30.

Augenklinik, Kantonsspital St. Gallen, Schweiz.

Background: Surgical treatment of abducens nerve palsy depends on the remaining function of the lateral rectus muscle. Vertical rectus transposition surgery is indicated if the attempted maximal abduction effort does not rotate the eye beyond the midline. After the first description more than 100 years ago, a variety of muscle transposition modifications have been suggested. Read More

Indian J Ophthalmol 2021 05;69(5):1142-1148

Department of Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya, Kolkata, (A Unit of Medical Research Foundation, Chennai, Tamil Nadu, India), India.

Purpose: The aim of this study was to describe epidemiological and clinical characteristics of pediatric ocular motor cranial nerve palsy.

Methods: This was a retrospective record-based study, carried out at a tertiary eye care hospital in India, between January 2011 and January 2015 and included patients up to 16 years of age at the time of presentation, diagnosed with third, fourth, sixth nerve palsy or a combination of these with other cranial nerve palsy. Data analyzed included demographic details, etiologies, presence or absence of amblyopia, relevant investigations, and management. Read More

Radiol Case Rep 2021 Jun 6;16(6):1339-1342. Epub 2021 Apr 6.

Neuroradiology Consultant, King Abdulaziz Hospital, Makkah, Saudi Arabia.

The oculomotor nerve palsy is a rare neurological deficit, it is associated with numerous underlying pathologies. Including stroke, neoplasms, trauma, post-surgical inflammation, and microvascular damage from chronic disease. It can cause a set of neurological deficits, including diplopia from oculomotor nerve involvement, decreased visual acuity from optic neuropathy, facial hypoesthesia from involvement of the trigeminal nerve, and less frequently facial pain. Read More

J Neuroophthalmol 2021 Apr 14. Epub 2021 Apr 14.

Strabismus, Pediatric and Neuro-Ophthalmology Services (MB), Jasti V Ramanamma Children's Eye Care Centre, L. V. Prasad Eye Institute, Hyderabad, India; and Department of Neuroradiology (SP), Citi Neuro Centre, Hyderabad, India.

Abstract: We report a rare case of isolated partial left III cranial nerve palsy due to inflammatory oculomotor neuritis after dengue fever with unique neuro-imaging findings of enhancement seen along the entire course of the oculomotor nerve. Read More

Neurochirurgie 2021 Apr 15. Epub 2021 Apr 15.

Department of neurosurgery, Democritus University of thrace, Alexandroupolis, Greece.

Objective: Posterior communicating artery aneurysms (PCoAA) usually present with brain hemorrhage, but they might present with oculomotor nerve palsy (ONP) in about one out of five patients. Treatment options include endovascular coiling and surgical clipping. The present analysis aims to compare the two treatment options for ONP due to PCoAA in terms of complete recovery and related parameters. Read More

Medicine (Baltimore) 2021 Apr;100(14):e25062

Department of Ophthalmology, Osaka Medical College, Osaka, Japan.

Rationale: Enlargemento of the medial rectus is the most predominant factor of compressive optic neuropathy (CON) in Graves' disease. This case report indicates that CON could develop only from the hypertrophic superior levator and superior rectus (SL/SR) muscle in a patient with poorly controlled Graves' disease, and described the possible risk of FT3-thyrotoxicosis with a prominent goiter to develop the current rare case with a review of the literature.

Patient Concerns: A 66-year-old woman undergoing endocrine management of hyperthyroidism with prominent goiter visited the Department of Ophthalmology due to right-eye upper-eyelid retraction. Read More

Neurology 2021 05 1;96(20):955-957. Epub 2021 Apr 1.

From the Truhlsen Eye Institute (J.J.G., S.K.), Department of Ophthalmology and Visual Sciences, and Departments of Neurological Sciences (J.A.F., S.K.) and Radiology (J.T.H.), University of Nebraska Medical Center, Omaha.

Zhongguo Zhen Jiu 2020 Nov;40(11):1232-4

First Clinical College, Guangzhou University of CM, Guangzhou 510405, Guangdong Province, China.

Professor -'s clinical experience of acupuncture for oculomotor nerve palsy was summarized and one typical case was introduced. Professor skillfully applied traditional acupuncture theory and classical acupuncture method, and proposed a diagnosis and treatment system combining meridian syndrome differentiation and specific acupuncture techniques. In addition, Professor combined the -primary and -connecting acupoints combination method, theory of "removing the stagnation of blood and " and theory of root-stem and origin-end, etc. Read More