Neuro-Ophthalmologic Evaluation of Oculomotor Nerve Paralysis

Green, W. R.; Hackett, Earl R.; Schlezinger, Nathan S.

doi:10.1001/archopht.1964.00970020154005

Cited by 172 publications

(62 citation statements)

References 27 publications

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“…In many cases the patient experiences pains during a few hours to a few days before noticing diplopia. Pain thus preceded the onset of diplopia in 14 out of the 25 patients reported by Green et al 11 . Pain seems more common when the third cranial nerve is affected than when the sixth nerve is involved.…”

Section: Frequency Of Involvement Of the Different Oculomotor Nerves -mentioning

confidence: 74%

Focal and multifocal diabetic neuropathies

Saïd

2007

Arq. Neuro-Psiquiatr.

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-Diabetic neuropathy is the most common neuropathy in industrialized countries, with a remarkable range of clinical manifestations. The vast majority of the patients with clinical diabetic neuropathy have a distal symmetrical form that progress following a fiber-length dependent pattern, with predominant sensory and autonomic manifestations. This pattern of neuropathy is associated with a progressive distal axonopathy. Patients are exposed to trophic changes in the feet, pains and autonomic disturbances. Less often, diabetic patients may develop focal and multifocal neuropathy that includes cranial nerve involvement, limb and truncal neuropathies. This neuropathic pattern tends to occur after 50 years of age, mostly in patients with longstanding diabetes mellitus. The LDDP does not show any trend to improvement and either relentlessly progresses or remain relatively stable over years. Conversely the focal diabetic neuropathies, which are often associated with inflammatory vasculopathy on nerve biopsies, remain self limited, sometimes after a relapsing course.KEY WORDS: diabetic neuropathy, diabetic ophthalmoplegia, proximal diabetic neuropathy, neuropathology, nerve biopsy. Neuropatia diabética focal e multifocalRESUMO -A neuropatia diabética é a mais predominante das neuropatias nos países industrializados apresentando uma gama variável de manifestações clinicas. A maioria dos pacientes com neuropatia diabética apresenta uma forma simétrica distal que progride para um padrão fibra comprimento dependente com manifestações sensitivas e autonomicas. Este tipo de neuropatia é associado com uma axonopatia distal progressiva. Os pacientes apresentam modificações tróficas nos pés, dores e distúrbios autonômicos. Menos freqüentemente os pacientes diabéticos podem desenvolver neuropatia focal e multifocal que incluem envolvimento de nervos cranianos, tronco e membros inferiores. Este padrão de neuropatia é mais freqüente em pacientes com mais de 50 anos e com longa historia de diabetes. Este tipo de neuropatia fibra-comprimento dependente não apresenta melhora, progride lentamente ou permanece estável por vários anos. As neuropatias focais que são associadas freqüentemente com vasculopatias inflamatórias nas biópsias de nervo, permanecem auto limitadas por vezes com surtos de remissão. PALAVRAS-CHAVE: neuropatia diabética, oftalmoplegia diabética, neuropatia proximal diabética, neuropatologia, biopsia de nervo. Prof. Diabetes mellitus is the most common cause of neuropathy in the world and an increasing burden in countries where obesity prevalence progresses. Most clinical manifestations of diabetic neuropathy had been identifi ed during the second half of the nineteenth century, but our knowledge on the pathology of diabetic neuropathies has been increased by the unexpected fi nding of infl ammatory lesions in focal diabetic neuropathies.Given that diabetes affects approximately 246 million people worldwide, it is estimated that 20-30 million people worldwide are affected by symptomatic diabetic neuropathy. G...

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Section: Frequency Of Involvement Of the Different Oculomotor Nerves -mentioning

confidence: 74%

Focal and multifocal diabetic neuropathies

Saïd

2007

Arq. Neuro-Psiquiatr.

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“…"The rule of the pupil" suggests that if a compressive lesion causes a third nerve palsy, the chances of pupil involvement are 95-97%. 9,10 In 32% cases of ischemic lesions pupil involvement may be seen.…”

Section: Fasciculus -mentioning

confidence: 99%

“…Therefore, its thorough evaluation is a must. 17,18 If a patient presents with sudden onset of severe headache, meningismus and photophobia with oculomotor nerve involvement, a non-contrast head computed tomography (CT) scan should be performed to rule out spontaneous subarachnoid hemorrhage; if CT is nondiagnostic, further lumbar puncture should be performed.…”

Section: Aberrant Regenerationmentioning

confidence: 99%

A Comprehensive Review on the Management of III Nerve Palsy

Ganger¹,

Yadav²,

Singh³

et al. 2016

DJO

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The third cranial nerve is a motor nerve chiefly involved in execution of movements of the eye. The paresis or paralysis of the one or more of these muscles due to oculomotor nerve palsy, leads to ptosis, anisocoria and ocular motility defects. This article highlights the origin and course from nuclear level to terminal branches along with associated clinical symptoms and signs that help in localizing the site of lesion and planning appropriate management.

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“…1) [Green et al, 1964;Frangois andNeetens, 1967, 1968;Neetens and Selosse, 1970;Segal and Fish man, 1975). Before ophthalmoscopic symp toms exist, pupillomotor anomalies may in dicate the diseased nerve: Marcus-Gunn test, pseudoanisocoria test of Kestcnbaum.…”

Section: Ophthalinological Symptomatologymentioning

confidence: 99%