Acute–onset diplopia

O'Colmain, Una; Gilmour, C. C. B.; MacEwen, C J

doi:10.1111/aos.12062

Cited by 36 publications

(23 citation statements)

References 7 publications

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“…The most common cause of binocular diplopia is isolated cranial nerve palsies (40-67%). [3][4][5] In our study we found cranial nerve palsies in 51.4% of our patients, of these 31.4 % were sixth nerve palsy, 11.4% third nerve palsy and 8.6% fourth nerve palsy. Merino et al similarly found the most frequent cause, as cranial nerve palsies and in their study, sixth nerve palsy was the most frequent.…”

Section: Discussionsupporting

confidence: 57%

“…6 The frequency of isolated nerve palsies was 53.7% in the study of O'Colmain and of these, 25.5% were sixth nerve palsies, 16.1% fourth nerve palsies and 12.1% third nerve palsies. 5 In early childhood, in the presence of acute esotropia, patients usually do not suffer from diplopia because of suppression. However, if acute esotropia develops in older ages, patients usually complain of diplopia.…”

Section: Discussionmentioning

confidence: 99%

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Etiology and Treatment Outcomes in Patients with Binocular Diplopia: Experience of a Tertiary Center

Kızıltunç¹,

Atilla²

2019

Turkiye Klinikleri J Ophthalmol

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iplopia is a common symptom in ophthalmological and neurological diseases and this symptom affects the quality of life to a great extent. Once the patient is disturbed from diplopia, it must be determined whether diplopia is monocular or binocular. While monocular Etiology and Treatment Outcomes in Patients with Binocular Diplopia: Experience of a Tertiary Center A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Diplopia is a common symptom in ophthalmologic and neurological diseases. In the presence of binocular diplopia, investigation should be made for differential diagnosis. Detection of the underlying etiology provides early diagnosis of accompanying neurological diseases and facilitates the treatment of diplopia. In this study, we aimed to evaluate the causes of binocular diplopia, treatment modalities and treatment outcomes in a tertiary center. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Medical records of patients with binocular diplopia were reviewed. Demographic features and ophthalmological examination findings were noted. Etiological differential diagnoses of diplopia were elucidated according to the results of full ophthalmological examination and neuro-radiological evaluation with cranio-orbital magnetic resonance imaging. Treatment modalities and responses to these treatments were noted. R Re es su ul lt ts s: : A total of 70 patients were evaluated. Thirty-six patients (51.4%) had cranial nerve palsies. Of 36 patients, 61.1% had 6th nerve palsy, 22.2% 3th nerve palsy and 16.7% 4th nerve palsy. Patients without cranial nerve palsies were also grouped according to the type of deviations. The most common deviations were acute-decompansated esotropia (21.2%) and agerelated esotropia (18.2%). Diplopia recovered in 8 patients (11.4%) after treatment of the underlying etiology. Nineteen (27.1%) patients were not treated due to spontaneous recovery. Prism glasses were prescribed in 22 (31.4%) patients. Twelve patients (17.1%) were operated. Six (8.6%) patients received Botulinum-A toxin injections. C Co on nc cl lu us si io on n: : In the presence of binocular diplopia, cranial nerve palsies should be investigated. Diplopia can resolve spontaneously. In cases with persistant diplopia, prism glasses, Botulinum toxin-A injection and surgery can be performed.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Etiology and Treatment Outcomes in Patients with Binocular Diplopia: Experience of a Tertiary Center

Kızıltunç¹,

Atilla²

2019

Turkiye Klinikleri J Ophthalmol

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“…26 Genel olarak, ileri yaşta akut başlan-gıçlı, pupiller tutulumun olmadığı hastalarda eşlik edebilen sistemik risk faktörlerinin araştırılması, görüntüleme yöntemlerinden ziyade etiyolojik araştırmada ilk tercih olmalıdır. 27 Üç ay içerisinde düzelmeyen ve vasküler patolojiye bağlı olduğu düşünülen hastalarda, özellikle anizokorinin >2 mm olduğu akut başlangıçlı hastalarda veya travma öyküsü olmayan genç hasta grubunda altta yatan sebebin ortaya çıkartılması için MRG'nin gerekliliği unutulmamalıdır. 18,[28][29][30][31][32][33] Bizim çalışmamızda, literatüre paralel olarak, 4. kraniyal sinir felci daha az oranda (%15,3) saptanmıştır.…”

Section: Discussionunclassified

Ocular Motor Nerve Palsies: Clinical and Etiological Analysis

Nalçacioğlu¹,

Kavuncu²,

Budakoglu³

et al. 2016

Turkiye Klinikleri J Ophthalmol

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Ö ÖZ ZE ET T A Am ma aç ç: : Oküler motor kraniyal sinir paralizisi olan hastaların etiyolojik ve klinik seyrinin retrospektif olarak değerlendirilmesidir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmamıza, Ulucanlar Göz Eğitim ve Araştırma Hastanesi Nörooftalmoloji Bölümüne 2003-2013 yılları arasında ardışık başvuran, düzenli takipleri olan 98 hasta dâhil edildi. Tüm hastaların ayrıntılı tıbbi öyküleri alındı, nörooftalmolojik muayeneleri yapıldı. Hastaların yaşı, cinsiyeti, eşlik eden sistemik hastalıkları, etiyolojisi, pupil çapı, pitozis varlığı ve şiddeti ve Hess ekranı ile değerlendirilen göz hareketleri geriye dönük olarak değerlendirildi. Etiyolojiye yönelik olarak görüntüleme yöntemlerine başvuruldu. B Bu ul lg gu ul la ar r: : Hastaların 45 (%45,9)'i kadın, 53 (%54,1)'ü erkek idi. Başvuru anındaki yaş ortalaması 53,6±17,5 (7-90) yıl idi. Ortalama izlem süresi 6,6±8,1 (3-64) ay idi. Her iki göz tutulumu 5 (%5,1) hastada mevcuttu. En sık izole altıncı kraniyal sinir (%48,9) felci izlenirken, bunu izole üçüncü kraniyal sinir (%34,6) felci izledi. İzole troklear sinir felci ise %15,3 oranında saptandı. Birden çok oküler motor sinir tutulumu ise 2 (%2,0) hastada izlendi. Oküler motor sinir felci ile pitoz %76,4 ve anizokori %17,6 oranında birliktelik göstermekte idi. Etiyolojik dağılımda hem altıncı sinir hem üçüncü kraniyal sinir için vaskü-ler sebepler (sırasıyla %68,7; %63,8), dördüncü kraniyal sinir felcinde ise kafa travması (%37,5) ön planda idi. S So on nu uç ç: : Bizim serimizde, oküler motor kraniyal sinir paralizilerinden en sık altıncı kraniyal sinir felci saptanırken, vasküler sebepler etiyolojik dağılımda ön planda idi. Imaging methods were used as required to determine the etiology. R Re es su ul lt ts s: : There were 45 (45.9%) female and 53 (54.1%) male patients. The mean age at presentation was 53.6±17.5 (7-90) years. The mean follow-up period was 6.6±8.1 (3-64) months. Five (5.1%) cases had bilateral involvement. The most commonly affected nerve was the sixth cranial nerve (48.9%) followed by the third cranial nerve (34.6%). Trochlear nerve palsy was identified at a rate of 15.3%. Multiple ocular nerve palsies were observed in 2 (2.0%) cases. Accompanying ptosis was found in 76.4% and anisocoria in 17.6%. The main cause was vascular disorders for both sixth and third cranial nerve palsy (68.7% and 63.8%, respectively) and head trauma for fourth cranial nerve palsy (37.5%). C Co on nc cl lu us si io on n: : Sixth cranial nerve palsy was the most common ocular motor cranial nerve palsy and a vascular disorder was the most frequent cause of these disorders.

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“…3 In these cases, a lesion is usually not found even by the current neuroimaging techniques. Although a brain tumour needs to be ruled out in cases of chronic abducens nerve palsy, abducens nerve palsy caused by a brain tumour is mostly accompanied by other cranial nerve palsies.…”

Section: Introductionmentioning

confidence: 99%

One-Sided Headache Is a Symptom Suggesting Aneurysmal Lesion in Patients with Isolated Abducens Nerve Palsy

Oku

Miyachi

Ikeda

2016

Neuro-Ophthalmology

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An isolated unilateral abducens nerve palsy or headache alone usually yields negative findings on neuroimages. The authors report an individual with right abducens nerve palsy who developed a sudden, persistent headache on the right side. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) revealed a giant aneurysm of the cavernous carotid artery that was located along the course of the right abducens nerve. The findings in this case of isolated abducens nerve palsy suggest that headaches should be considered as important signs for intracranial aneurysmal lesions. ARTICLE HISTORY

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Acute–onset diplopia

Cited by 36 publications

References 7 publications

Etiology and Treatment Outcomes in Patients with Binocular Diplopia: Experience of a Tertiary Center

Etiology and Treatment Outcomes in Patients with Binocular Diplopia: Experience of a Tertiary Center

Ocular Motor Nerve Palsies: Clinical and Etiological Analysis

One-Sided Headache Is a Symptom Suggesting Aneurysmal Lesion in Patients with Isolated Abducens Nerve Palsy

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