1/51. Congenital upper eyelid retraction.This report describes a six-year-old boy born with a unilateral upper eyelid retraction resulting in mild exposure keratopathy. The fissure on that side was 4 millimeters larger and lagophthalmos was present. At the time of levator recession surgery, the muscle was found to have a restriction at the medial and lateral horns preventing downward excursion. This condition has some of the features of congenital orbital fibrosis and is postulated to have been due to an intrauterine infection or inflammation.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
2/51. Recurrent isolated ptosis in presumed ophthalmoplegic migraine of childhood.PURPOSE: To report a rare case of isolated, recurrent unilateral eyelid ptosis as the sole manifestation of ophthalmoplegic migraine in a healthy young girl. DESIGN: Single observational case report with review of the literature. TESTING: Serologic evaluation, electromyographic, nerve conduction and Tensilon testing, magnetic resonance and computerized tomographic imaging, and magnetic resonance angiography were performed. MAIN OUTCOME MEASURES: Four-year descriptive history of recurrent eyelid ptosis. RESULTS: Between 1994 and 1998, seven discrete episodes of right upper eyelid ptosis without ophthalmoplegia or pupil abnormality occurred. On each occasion, spontaneous resolution occurred over a period of 6 to 10 weeks. Extensive clinical and laboratory evaluation, including testing for myasthenia gravis and magnetic resonance cerebral angiography, was unremarkable. CONCLUSIONS: Recurrent isolated ptosis is a rare manifestation of presumed ophthalmoplegic migraine in childhood. As far as we are aware, this has not been previously reported.- - - - - - - - - - ranking = 0.2keywords = upper (Clic here for more details about this article) |
3/51. Unilateral acquired upper eyelid ptosis and decreasing nystagmus.PURPOSE: To describe a patient with congenital nystagmus that decreased in one eye after the development of a cavernous sinus meningioma. DESIGN: Interventional case report. methods: A 45-year-old man with congenital nystagmus, albinism, and high myopia presented with right upper eyelid ptosis that was corrected surgically on three occasions during a 3-year period. An episode of syncope was followed by diagnostic evaluation that disclosed a cavernous sinus meningioma. He commented that his right eye nystagmus progressively decreased. He was found to have ophthalmoplegia on the right eye due to nerve compression by the meningioma. RESULTS: A magnetic resonance imaging scan disclosed a cavernous sinus meningioma extending into the parachiasmal and clival areas. A biopsy specimen of the lesion demonstrated a meningioma. CONCLUSIONS: Any patient with acquired ptosis should have a complete ophthalmic examination, including evaluation of extraocular motility.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
4/51. Transient impaired vision, external ophthalmoplegia, and internal ophthalmoplegia after blepharoplasty under local anesthesia.PURPOSE: To report a case of transient bilateral vision impairment with external ophthalmoplegia and internal ophthalmoplegia after blepharoplasty under local anesthesia. DESIGN: Interventional case report. methods: A 70-year-old man underwent bilateral upper blepharoplasty under local anesthesia. During orbital fat removal additional anesthetic was injected into both medial fat pads for pain control. RESULTS: Immediate postoperative examination revealed bilateral decreased visual acuity and internal ophthalmoplegia in the right eye. An exotropia was present with marked limitation of right eye adduction. These findings resolved completely 3 hours postoperatively. CONCLUSIONS: Local anesthesia during blepharoplasty can enervate the optic nerve, ciliary ganglion, and extraocular muscle nerves. Local anesthesia should be injected judiciously during orbital fat removal to avoid this reversible but alarming event.- - - - - - - - - - ranking = 0.2keywords = upper (Clic here for more details about this article) |
5/51. Superior oblique tendon sheath syndrome: an unusual case.It is now recognized that the clinical findings of Brown's superior oblique tendon sheath syndrome can be caused by a variety of abnormalities. This has led to classification into "true" and "simulated" sheath syndromes. This report describes a case of simulated sheath syndrome caused by an anomalous fibrous band between the superior oblique tendon sheath and the upper nasal intermuscular quadrant. This unusual anomaly results in functional shortening of the sheath. Division of the band eliminated the restrictions on traction test and improved elevation in all fields postoperatively.- - - - - - - - - - ranking = 0.2keywords = upper (Clic here for more details about this article) |
6/51. Ocular myopathy without ophthalmoplegia can be a form of mitochondrial myopathy.To characterize muscle pathology in 3 cases affected by ocular myopathy with eyelid ptosis and upper facial weakness, but without ophthalmoplegia, light microscopy and ultrastructural study were performed on levator palpebrae, orbicularis oculi and deltoid muscle biopsies. While levator palpebrae proved uninformative because of the massive fibrous degeneration of muscle, orbicularis oculi biopsies showed histochemical and ultrastructural alterations indicating a mitochondrial involvement, resembling that reported in ocular mitochondrial myopathies (OMM). On the other hand very mild aspecific findings were observed in deltoid. We suggest that these cases with ocular myopathy and without ophthalmoplegia should be considered a partial or initial form of OMM.- - - - - - - - - - ranking = 0.2keywords = upper (Clic here for more details about this article) |
7/51. Bilateral medial medullary infarction with oculomotor disorders.BACKGROUND AND PURPOSE: We describe the first case of bilateral medial medullary infarction demonstrated by magnetic resonance imaging. We discuss the relation between this lesion and the oculomotor signs that were observed clinically. CASE DESCRIPTION: A 71-year-old man initially presented with pure motor hemiparesis, which progressed to complete quadriplegia. He also developed nearly complete vertical and horizontal ophthalmoplegia. magnetic resonance imaging revealed upper medial medullary infarctions bilaterally that extended to the pontomedullary junction. CONCLUSIONS: We propose that the vertical oculomotor disorders resulted from involvement of the oculomotor system in the caudal brain stem, especially the caudal paramedian pontine reticular formations on both sides.- - - - - - - - - - ranking = 0.2keywords = upper (Clic here for more details about this article) |
8/51. A lot of clot.A 37-year-old man presented with fever and a red, painful right eye. He had proptosis, conjunctival chemosis, and ophthalmoplegia OD. The patient had extremely poor dentition and had self decompressed a dental abscess prior to admission. magnetic resonance imaging of the brain and orbital revealed extraocular muscle engorgement and a dilated superior ophthalmic vein OD. Orbital echography revealed a lack of flow in the right superior ophthalmic vein. An extensive hematologic evaluation for infection and inflammation was negative. A chest radiograph showed a lung abscess for which he received intravenous antibiotics. Over time, the periorbital erythema, ophthalmoplegia, proptosis, and pain resolved. Repeat MRI showed resolution of the orbital findings and repeat chest x-ray showed resolution of the left upper lobe abscess.- - - - - - - - - - ranking = 0.2keywords = upper (Clic here for more details about this article) |
9/51. Vasogenic edema in Bickerstaff's brainstem encephalitis: a serial MRI study.The authors report serial MRI of a patient with Bickerstaff's brainstem encephalitis (BBE), disclosing caudal migration of an initial upper midbrain lesion. High apparent diffusion coefficient values imply a vasogenic rather than cytotoxic edema as the cause of the hyperintense signal changes on T2-weighted images.- - - - - - - - - - ranking = 0.2keywords = upper (Clic here for more details about this article) |
10/51. Spinocerebellar ataxia type 2 (SCA2) presenting with ophthalmoplegia and developmental delay in infancy.An 11-year-old boy was evaluated for progressive ataxia, cognitive deterioration, and ophthalmoplegia. The child initially presented with abnormal eye movements at the age of 2 months and was noted to have developmental delay at 6 months. At the age of 7 years, he developed ataxia and cognitive impairment, and subsequently manifested dysphagia and incontinence. The pertinent family history included gait difficulty in the paternal grandmother. At the age of 11, his general physical examination was normal. On neurological examination, he had bilateral external ophthalmoplegia, ataxic dysarthria, dysmetria and tremor in the upper extremities, and marked gait ataxia. An ophthalmological evaluation showed no evidence of pigmentary retinopathy. brain MRI demonstrated cerebellar, brainstem, and cerebral atrophy. An ataxia panel showed 62 repeats in one allele of the SCA2 gene. Most cases of spinocerebellar ataxia type 2 (SCA2) present between 20 years and 40 years, and affected individuals typically have between 34 and 57 CAG repeats. Neonatal cases of SCA2 have been reported in individuals with over 200 CAG repeats. Childhood SCA2 has been reported previously in two patients but not described clinically. This case broadens the spectrum of the clinical features of infantile-onset SCA2 and highlights the importance of considering this diagnosis in infants and children.- - - - - - - - - - ranking = 0.2keywords = upper (Clic here for more details about this article) |
| | Next -> |