14,467 results match your criteria external ophthalmoplegia

Rhino-orbital mucormycosis during steroid therapy in COVID-19 patients: A case report.

Eur J Ophthalmol 2021 Apr 10:11206721211009450. Epub 2021 Apr 10.

Depatment of Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Purpose: To report two cases of COVID-19 under treatment with a corticosteroid; in one case rhino-orbitocerebral mucormycosis and in another one rhino-orbital mucormycosis developed.

Case Presentation: A 40-year old woman and a 54-year old man with severe COVID-19 underwent corticosteroid therapy for immune-related lung injuries. The first case presented with a bilateral visual loss and complete ophthalmoplegia of the right eye. Read More

View Article and Full-Text PDF

Orbital infarction syndrome following hyaluronic acid filler rhinoplasty.

Luai Eldweik

Am J Ophthalmol Case Rep 2021 Jun 18;22:101063. Epub 2021 Mar 18.

Eye Institute, Cleveland Clinic Abu Dhabi, C7-257 Swing Wing, Al Maryah Island, Abu Dhabi, 112412, United Arab Emirates.

Purpose: Over the last decade, injectable soft tissue fillers have become an essential part of facial plastic surgery practice. We report here a tragic complication of hyaluronic acid filler injection in a young healthy woman, management offered, and the outcome.

Observations: A 32-year-old woman developed unilateral acute blindness, orbital pain, total ophthalmoplegia, and anterior and posterior segment ischemia immediately following hyaluronic acid injection. Read More

View Article and Full-Text PDF

[Progressive supranuclear paralysis with levodopa-induced dyskinesia].

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(3):110-115

Bashkir State Medical University, Ufa, Russia.

Progressive supranuclear palsy (PNP) is a neurodegenerative disease characterized by a combination of progressive akinetic-rigid syndrome, postural instability with frequent falls, supranuclear ophthalmoplegia, pseudobulbar syndrome and frontal dementia. The disease usually develops after the sixth decade of life, and has a progressive course. An own description of the clinical case of progressive supranuclear palsy in a 79-year-old patient with oromandibular hyperkinesis while taking levodopa is presented. Read More

View Article and Full-Text PDF

Bilateral persistent ophthalmoplegia in a patient with migraine: persistent migraine aura without infarction?

BMJ Case Rep 2021 Apr 7;14(4). Epub 2021 Apr 7.

Department of Medicine, Smt BK Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth, Waghodia, Gujarat, India.

Migraine auras typically last for 5-60 min. An aura that persists for more than a week without evidence of infarction on neuroimaging is called persistent aura without infarction. Persistent migraine aura without infarction is usually described with visual auras. Read More

View Article and Full-Text PDF

Successful treatment of rhino-orbital-cerebral mucormycosis with isavuconazole salvage therapy following extensive debridement.

Med Mycol Case Rep 2021 Jun 17;32:39-42. Epub 2021 Mar 17.

Department of Ear, Nose & Throat (ENT) Surgery, Queen Elizabeth University Hospital, Glasgow, UK.

A 61-year old lady with poorly-controlled type 2 diabetes mellitus was diagnosed with rhino-orbital-cerebral mucormycosis following presentation with sinusitis, ophthalmoplegia, proptosis and facial numbness. She was treated successfully with aggressive surgical intervention including orbital exenteration, accompanied by anti-fungal therapy with liposomal amphotericin B and posaconazole, followed by isavuconazole as salvage therapy. We discuss the challenges around optimising antifungal therapy of this lethal infection in the context of hepatic and renal toxicity. Read More

View Article and Full-Text PDF

MRI topography of lesions related to internuclear ophthalmoplegia in patients with multiple sclerosis or ischemic stroke.

J Neuroimaging 2021 Apr 1. Epub 2021 Apr 1.

Department of Neurology, Medical Faculty Mannheim and Mannheim Center for Translational Neurosciences (MCTN), University of Heidelberg, Mannheim, Germany.

Background And Purpose: Internuclear ophthalmoplegia is a dysfunction of conjugate eye movements, caused by lesions affecting the medial longitudinal fasciculus (MLF). Multiple sclerosis (MS) and ischemic stroke represent the most common pathophysiologies. While magnetic resonance imaging (MRI) allows for localizing lesions affecting the MLF, comprehensive comparative studies exploring potential different spatial characteristics of lesions affecting the MLF are missing until now. Read More

View Article and Full-Text PDF

A Post-Infectious Steroid-Responsive Brainstem Lesion Associated With COVID-19.

Neurohospitalist 2021 Apr 22;11(2):152-155. Epub 2020 Sep 22.

Department of Neurology, Kaiser Permanente Santa Clara Medical Center, Assistant Professor of Neurology, Boston University Medical School, Santa Clara, CA, USA.

A 51-year-old man developed coma, bilateral pupillary dilation, ophthalmoplegia and quadriplegia 4 weeks after testing positive for COVID-19. MRI demonstrated a symmetric midline pontine non-enhancing T2-FLAIR hyperintense lesion. The patient was treated with intravenous methylprednisolone, which resulted in improvement of his Glasgow Coma Scale (GCS) from 3 to 15 over the next 5 days. Read More

View Article and Full-Text PDF

Wernicke-Korsakoff Syndrome in Hyperemesis Gravidarum: A Case Report and Literature Review.

Neurohospitalist 2021 Apr 4;11(2):141-147. Epub 2020 Sep 4.

Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Philippines.

Background: Wernicke-Korsakoff syndrome (WKS) is a triad of ophthalmoplegia, ataxia and memory deficits due to thiamine insufficiency resulting from under- or untreated Wernicke's encephalopathy (WE), which may be associated with hyperemesis gravidarum (HEG).

Case Presentation: We present a case of a 36-year-old Filipino woman in her first trimester with HEG, along with the WKS triad and abnormal hyperintense signals in the bilateral thalami and midbrain, left occipital lobe, periaqueductal gray matter and pontine periventricular areas. Neurologic deficits partially improved but persisted despite intravenous thiamine administration. Read More

View Article and Full-Text PDF

Acute-onset binocular diplopia in neurological unit: Aetiological factors and diagnostic assessment.

Acta Neurol Scand 2021 Mar 31. Epub 2021 Mar 31.

Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.

Objectives: To investigate the aetiology of acute-onset binocular diplopia (AOBD) in neurological units and identify the key diagnostic procedures in this setting.

Materials And Methods: Clinico-demographic data from patients hospitalized for AOBD from 2008 to 2019 were retrospectively reviewed. AOBD due to an underlying neurological disorder known to cause diplopia was addressed as secondary diplopia. Read More

View Article and Full-Text PDF

Evolving resting head tremor in parkinsonism: Clinicopathological study of a case.

Parkinsonism Relat Disord 2021 Mar 13;86:1-4. Epub 2021 Mar 13.

Saskatchewan Movement Disorders Program, Saskatchewan Health Authority/University of Saskatchewan, Canada. Electronic address:

Introduction: Resting limb tremor (RLT) is a well known feature in parkinsonism. There is very little information on resting head tremor (RHT) in parkinsonism, and none in pathologically confirmed cases. The association between RLT and RHT remains uncertain. Read More

View Article and Full-Text PDF

Double-hit and triple-hit high-grade B-cell lymphoma of the ocular adnexa.

Orbit 2021 Mar 29:1-5. Epub 2021 Mar 29.

Department of Pathology, Wills Eye Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

High-grade B-cell lymphoma (HGBL) with and and/or rearrangements, also known as a double-hit and triple-hit lymphoma, is an aggressive non-Hodgkin lymphoma affecting older adults. After formal recognition of this entity in the 2017 revision of the World Health Organization Classification of lymphoid neoplasms, only two well-documented cases of triple-hit lymphoma of the orbit appear in the literature. Herein, we describe a 70-year-old man with progressive diplopia, ophthalmoplegia, and rapidly enlarging temporal mass. Read More

View Article and Full-Text PDF

A Meta-Analysis of Traumatic Orbital Apex Syndrome and the Effectiveness of Surgical and Clinical Treatments.

J Craniofac Surg 2021 Mar 22. Epub 2021 Mar 22.

Division of Plastic Surgery, Albany Medical Center, Albany Division of Plastic and Reconstructive Surgery, Montefiore Medical Center, Bronx, NY.

Purpose: Traumatic orbital apex syndrome (TOAS) commonly occurs secondary to trauma and irreversible ischemic optic neuropathy occurs as early as 2 hours after injury. Multiple treatment options have been described, however, there is a lack of consensus regarding the optimal treatment of these patients.

Methods: A systematic review of the PubMed Database from 1970 to 2020 was conducted, using the search terms "orbital apex," "syndrome," and "traumatic" with the Boolean operators "AND" or "OR. Read More

View Article and Full-Text PDF

Bypass Surgery to Treat Giant Cavernous Carotid Artery Aneurysms.

J Craniofac Surg 2021 Mar 24. Epub 2021 Mar 24.

Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University Department of Neurosurgery, Tianjin Huanhu Hospital Department of Graduate School, Nan Kai University, Tianjin, China.

Background: With the development of bypass technique, more and more complex aneurysms can be treated with bypass surgery. The goal of this study is to evaluate the efficacy and safety of bypass in patients with giant cavernous carotid aneurysms (GCCAs). To further discuss the treatment of asymptomatic GCCAs. Read More

View Article and Full-Text PDF

Neuro-ophthalmic manifestations of mitochondrial disorders and their management.

Taiwan J Ophthalmol 2021 Jan-Mar;11(1):39-52. Epub 2020 Dec 4.

Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.

The visual system has high metabolic requirements and is therefore particularly vulnerable to mitochondrial dysfunction. The most commonly affected tissues include the extraocular muscles, photoreceptors, retinal pigment epithelium, optic nerve and visual cortex. Hence, the most common manifestations of mitochondrial disorders are progressive external ophthalmoplegia, macular pattern dystrophy, pigmentary retinopathy, optic neuropathy and retrochiasmal visual field loss. Read More

View Article and Full-Text PDF
December 2020

Atypical presentations of idiopathic intracranial hypertension.

Taiwan J Ophthalmol 2021 Jan-Mar;11(1):25-38. Epub 2020 Dec 2.

Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, United States.

Idiopathic intracranial hypertension (IIH) is a disorder of unknown etiology that results in isolated raised intracranial pressure. Classic symptoms and signs of IIH include headache, papilledema, diplopia from sixth nerve palsy and divergence insufficiency, and pulsatile tinnitus. Atypical presentations include: (1) highly asymmetric or even unilateral papilledema, and IIH without papilledema; (2) ocular motor disturbances from third nerve palsy, fourth nerve palsy, internuclear ophthalmoplegia, diffuse ophthalmoplegia, and skew deviation; (3) olfactory dysfunction; (4) trigeminal nerve dysfunction; (5) facial nerve dysfunction; (6) hearing loss and vestibular dysfunction; (7) lower cranial nerve dysfunction including deviated uvula, torticollis, and tongue weakness; (8) spontaneous skull base cerebrospinal fluid leak; and (9) seizures. Read More

View Article and Full-Text PDF
December 2020

Primary isolated amyloidosis in the extraocular muscle as a rare cause of ophthalmoplegia: A case report and literature review.

Am J Ophthalmol Case Rep 2021 Jun 26;22:101052. Epub 2021 Feb 26.

Department of Ophthalmology, Asahikawa Medical University, 2-1-1 Midorigaoka, Higashi, Asahikawa, Hokkaido, 078-8510, Japan.

Purpose: To report a case of external ophthalmoplegia due to an uncommon form of amyloidosis exclusively affecting the lateral rectus muscle, and to discuss the clinical manifestation, diagnostic challenges, and management pitfalls of isolated amyloidosis in the extraocular muscle.

Observations: A 64-year-old woman presented with diplopia in her left gaze lasting for six months. She had orthophoria in the primary position and abduction limitation in the left eye. Read More

View Article and Full-Text PDF

Hemisensory loss in myasthenia gravis.

BMJ Case Rep 2021 Mar 17;14(3). Epub 2021 Mar 17.

Department of Neurology, Orlando Veterans Affairs Medical Center-Lake Nona, Orlando, Florida, USA.

A 73-year-old white man presents with left-sided ptosis and diplopia in the absence of ophthalmoplegia, with left hemibody paresthesia. He reports intermittent dysphagia and dizziness for 1 month and diarrhoea for 2 months. Serum and electrodiagnostic studies confirmed the diagnosis of myasthenia gravis. Read More

View Article and Full-Text PDF

Mitophagy: An Emerging Target in Ocular Pathology.

Invest Ophthalmol Vis Sci 2021 Mar;62(3):22

Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States.

Mitochondrial function is essential for the viability of aerobic eukaryotic cells, as mitochondria provide energy through the generation of adenosine triphosphate (ATP), regulate cellular metabolism, provide redox balancing, participate in immune signaling, and can initiate apoptosis. Mitochondria are dynamic organelles that participate in a cyclical and ongoing process of regeneration and autophagy (clearance), termed mitophagy specifically for mitochondrial (macro)autophagy. An imbalance in mitochondrial function toward mitochondrial dysfunction can be catastrophic for cells and has been characterized in several common ophthalmic diseases. Read More

View Article and Full-Text PDF

Clinical and molecular characterization of mitochondrial DNA disorders in a group of Argentinian pediatric patients.

Mol Genet Metab Rep 2021 Jun 25;27:100733. Epub 2021 Feb 25.

Department of Medical Genetics, Hospital de Pediatría "Juan P. Garrahan", Combate de los Pozos 1881, Buenos Aires 1245, Argentina.

Objective: To describe the clinical and molecular features of a group of Argentinian pediatric patients with mitochondrial DNA (mtDNA) disorders, and to evaluate the results of the implementation of a classical approach for the molecular diagnosis of mitochondrial diseases.

Methods: Clinical data from 27 patients with confirmed mtDNA pathogenic variants were obtained from a database of 89 patients with suspected mitochondrial disease, registered from 2014 to 2020. Clinical data, biochemical analysis, neuroimaging findings, muscle biopsy and molecular studies were analyzed. Read More

View Article and Full-Text PDF

Neurologic Manifestations of the World Health Organization's List of Pandemic and Epidemic Diseases.

Front Neurol 2021 22;12:634827. Epub 2021 Feb 22.

Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.

The World Health Organization (WHO) monitors the spread of diseases globally and maintains a list of diseases with epidemic or pandemic potential. Currently listed diseases include Chikungunya, cholera, Crimean-Congo hemorrhagic fever, Ebola virus disease, Hendra virus infection, influenza, Lassa fever, Marburg virus disease, , MERS-CoV, monkeypox, Nipah virus infection, novel coronavirus (COVID-19), plague, Rift Valley fever, SARS, smallpox, tularemia, yellow fever, and Zika virus disease. The associated pathogens are increasingly important on the global stage. Read More

View Article and Full-Text PDF
February 2021

Case Report: Early-Onset Guillain-Barre Syndrome Mimicking Stroke.

Front Neurol 2021 19;12:525699. Epub 2021 Feb 19.

Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China.

Guillain-Barre syndrome (GBS) is an acute immune-mediated inflammatory demyelinating polyneuropathy characterized by symmetrical limb weakness and areflexia. GBS can have different clinical manifestations; hence, the initial symptoms are also varied. Here, we describe a rare case of GBS presenting as hemiparesis and cranial nerve palsy, which mimic brainstem stroke. Read More

View Article and Full-Text PDF
February 2021

Miller Fisher syndrome associated with COVID-19: an up-to-date systematic review.

Environ Sci Pollut Res Int 2021 Mar 6. Epub 2021 Mar 6.

Department of Anaesthesia and Intensive Care and Peter Hung Pain Research Institute, The Chinese University of Hong Kong, Hong Kong, China.

Recently, during the pandemic infection of the novel SARS-CoV-2, some cases of Miller Fisher syndrome (MFS) have been reported. We want to summarize the main features of patients with MFS and COVID-19. A PubMed search was performed on 8 October to identify references reporting cases with MFS associated with COVID-19 from the first report of COVID-19 to 8 October 2020 using the following keywords: "Miller Fisher syndrome" AND "COVID-19" OR "SARS-CoV-2". Read More

View Article and Full-Text PDF

High-resolution MR imaging of cranial neuropathy in patients with anti-GQ1b antibody syndrome.

J Neurol Sci 2021 04 27;423:117380. Epub 2021 Feb 27.

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu Seoul 05505, Republic of Korea.

Objective: The value of conventional MRI in patients anti-GQ1b antibody syndrome is subject to debate. Our purpose was to evaluate the diagnostic accuracy of high-resolution MRI for detecting cranial nerve abnormalities in patients with anti-GQ1b antibody syndrome.

Materials And Methods: This retrospective cohort study enrolled 15 anti-GQ1b-positive patients diagnosed with MFS and related disorders and 17 age-matched controls, all of whom underwent high-resolution MR imaging including pre-contrast and contrast-enhanced (CE) 3D FLAIR and 3D CE T1-weighted turbo field echo (T1-TFE) between 2010 and 2016. Read More

View Article and Full-Text PDF

A New Intronic Variant in ECEL1 in Two Patients with Distal Arthrogryposis Type 5D.

Int J Mol Sci 2021 Feb 20;22(4). Epub 2021 Feb 20.

Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy.

Distal Arthrogryposis type 5D (DA5D) is characterized by congenital contractures involving the distal joints, short stature, scoliosis, ptosis, astigmatism, and dysmorphic features. It is inherited in an autosomal recessive manner, and it is a result of homozygous or compound heterozygous variants in the ECEL1 gene. Here, we report two patients of Sardinian origin harboring a new intronic homozygous variant in ECEL1 (c. Read More

View Article and Full-Text PDF
February 2021

MITOL-dependent ubiquitylation negatively regulates the entry of PolγA into mitochondria.

PLoS Biol 2021 Mar 3;19(3):e3001139. Epub 2021 Mar 3.

National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi, India.

Mutations in mitochondrial replicative polymerase PolγA lead to progressive external ophthalmoplegia (PEO). While PolγA is the known central player in mitochondrial DNA (mtDNA) replication, it is unknown whether a regulatory process exists on the mitochondrial outer membrane which controlled its entry into the mitochondria. We now demonstrate that PolγA is ubiquitylated by mitochondrial E3 ligase, MITOL (or MARCH5, RNF153). Read More

View Article and Full-Text PDF

A rare case of unilateral Cogan's anterior internuclear ophthalmoplegia, upgaze palsy and ataxia caused by dorsal tegmentum lesion at pontomesencephalic junction.

BMC Ophthalmol 2021 Feb 25;21(1):105. Epub 2021 Feb 25.

Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Sarawak, Malaysia.

Background: Cogan's anterior internuclear ophthalmoplegia (INO) is characterized by INO with inability to converge and commonly thought to be due to rostral midbrain lesion. A lesion outside midbrain that causes unilateral Cogan's anterior INO combined with upgaze palsy and ataxia are rarely described.

Case Presentation: A 67-year old male presented with left Cogan's anterior internuclear ophthalmoplegia (INO), left appendicular ataxia and bilateral upgaze palsy. Read More

View Article and Full-Text PDF
February 2021