Possible Causes for disconjugate eye movement Primary Progressive Multiple Sclerosis We present three patients with a clinical course and cerebrospinal fluid findings consistent with a diagnosis of primary progressive multiple sclerosis (PPMS). Extensive and repeated magnetic resonance imaging (MRI) examinations showed only diffuse abnormality in brain and spinal cord, but no focal lesions. We propose[…] [ncbi.nlm.nih.gov] Brain Stem Infarction Moyamoya disease (MMD) is a rare cerebrovascular disease with an unknown etiology and is characterized by intrinsic fragility in the intracranial vascular walls such as the affected internal elastic lamina and thinning medial layer. The association of MMD with intracranial arterial dissection is extremely rare, whereas[…] [ncbi.nlm.nih.gov] General Anesthesia We report the successful management of general anesthesia for a patient with Pelizaeus-Merzbacher disease (PMD). PMD is one of a group of progressive, degenerative disorders of the cerebral white matter. The typical clinical manifestations of PMD include psychomotor retardation, nystagmus, abnormal muscle tone,[…] [ncbi.nlm.nih.gov] Multiple Sclerosis Multiple sclerosis (MS) is an inflammatory demyelinating disease of central nervous system and it is associated with an impaired motor function status. The efficacy of rehabilitation in promoting functional recovery and increasing quality of life in MS patients has been demonstrated. A 47-year-old woman was diagnosed[…] [ncbi.nlm.nih.gov] Alternating Exotropia Abstract We studied the coordination of binocular eye movements in human subjects with alternating exotropia (divergent strabismus). Binocular saccades were recorded in six subjects during binocular and monocular viewing. Subjects were instructed to make saccades between two continuously lit targets (LED's)[…] [ncbi.nlm.nih.gov] Wernicke Encephalopathy Wernicke encephalopathy is an acute neurological problem resulting from thiamine deficiency and manifesting with mental confusion, oculomotor dysfunction, and ataxia. It is associated with alcohol dependence in adults. Preparatory factors include hyperemesis gravidarum, prolonged diarrhea, prolonged parental nutrition[…] [ncbi.nlm.nih.gov] Brain Stem Hemorrhage We report findings from an autopsy of a male in his 40s who died of a brain stem hemorrhage associated with cerebral amyloid angiopathy (CAA), senile plaques (SPs) and neurofibrillary tangles (NFTs), which are histopathological changes associated with Alzheimer's disease (AD). Our immunohistochemical study[…] [ncbi.nlm.nih.gov] Progressive Supranuclear Palsy Progressive supranuclear palsy (PSP) may be a risk factor for thiamine deficiency. The classic symptoms of PSP (postural instability, supranuclear vertical gaze palsy and dementia) overlap with the clinical triad of Wernicke's encephalopathy (cognitive impairment, gait problems and ocular abnormality). Therefore,[…] [ncbi.nlm.nih.gov] Tricyclic Antidepressant Overdose Abstract In order to evaluate the enzymes CPK and LDH as potential biochemical markers of tricyclic antidepressant (TCA) cardiotoxicity, we prospectively followed 29 patients with TCA overdose. Serum CPK and LDH were obtained on all patients at admission. Population characteristics included a mean age of 33 y, a[…] [ncbi.nlm.nih.gov] Benign Abducens Nerve Palsy PURPOSE: Benign abducens nerve palsy is rare in childhood. Diagnosis is made by exclusion, and the severe underlying pathologies have to be ruled out. The aim of our study was to present the largest single-center series of patients with the longest period of follow-up to confirm the benign nature of this entity.[…] [ncbi.nlm.nih.gov] Abducens Nerve Palsy Cranial nerve VI, also known as the abducens nerve, innervates the ipsilateral lateral rectus (LR), which functions to abduct the ipsilateral eye. The sixth cranial nerve has a long subarachnoid course. The sixth nerve nucleus is located in the pons, just ventral to the floor of the fourth ventricle and just lateral[…] [emedicine.com] Oculomotor Nerve Paralysis Möbius syndrome is typified by bilateral facial nerve palsies, usually with abducens palsies. We examined an infant with Möbius syndrome who had bifacial weakness and third nerve palsies, but intact abduction of both eyes. Lower cranial nerve involvement, leading to respiratory, swallowing, and cardiac difficulties, was[…] [ncbi.nlm.nih.gov] Barbiturate Overdose Barbiturate overdose is poisoning due to excessive doses of barbiturates. Symptoms typically include difficulty thinking, poor coordination, decreased level of consciousness, and a decreased effort to breathe (respiratory depression). Complications of overdose can include noncardiogenic pulmonary edema. If death[…] [en.wikipedia.org] Marchiafava-Bignami Disease Radiol Case Rep. 2016 Sep; 11(3): 234–237. Abstract Marchiafava–Bignami disease is a rare toxic encephalopathy seen mostly in chronic alcoholics due to progressive demyelination and necrosis of the corpus callosum. It may involve adjacent white matter and subcortical regions. We present here the magnetic resonance[…] [ncbi.nlm.nih.gov] Esophoria BACKGROUND: We previously reported results of a randomized clinical trial of bifocals as a type of myopia correction for children with near-point esophoria. After 30 months, the rate of myopia progression in 36 children wearing bifocals averaged 0.40 D/yr compared to 0.50 D/yr in 39 children wearing single-vision[…] [ncbi.nlm.nih.gov] Trochlear Nerve Paralysis NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version Click here for the Professional Version A palsy of the 4th cranial nerve affects vertical eye movements. Often doctors cannot identify the cause, but when they can, the cause is usually a head injury, sometimes a minor one.[…] [merckmanuals.com] Brain Stem Disorder Protopopescu, X., Pan, H., Tuescher, O., Cloitre, M., Goldstein, M., Engelien, A., ... Silbersweig, D. (2006). Increased brainstem volume in panic disorder: A voxel-based morphometric study. NeuroReport, 17 (4), 361-363. Increased brainstem volume in panic disorder : A voxel-based morphometric study. / Protopopescu, Xenia;[…] [nyuscholars.nyu.edu] Ocular Palsy OBJECTIVES: In this prospective study, we used one diagnostic protocol to establish an early diagnosis in patients with ocular palsies in absence of other neurological findings. MATERIALS AND METHODS: The study was performed on a consecutive series of 132 patients who visited our Neurological Department for ptosis[…] [ncbi.nlm.nih.gov] Ophthalmoplegia Ophthalmoparesis refers to weakness (-paresis) or paralysis (-plegia) of one or more extraocular muscles which are responsible for eye movements. It is a physical finding in certain neurologic, ophthalmologic, and endocrine disease. Internal ophthalmoplegia means involvement limited to the pupillary sphincter and ciliary[…] [en.wikipedia.org] Scorpion Sting A seven-year-old girl, stung by a scorpion, was hospitalized in a confused state with signs of myocarditis and pulmonary edema. In spite of clinical improvement within 24 h, 14 serial echocardiograms and electrocardiograms performed during a four-month period showed severe changes. There have been no previously[…] [ncbi.nlm.nih.gov] Thallium Poisoning Thallium has been responsible for many intoxications since its discovery; however, toxicological profiles for thallium in human fatalities have not been updated recently. Autopsy, microscopic investigations, and toxicological analyses were performed on a married couple who died from thallium sulfate intended homicidal[…] [ncbi.nlm.nih.gov] Benedict Syndrome Benedict syndrome Sindrom otak tengah mempengaruhi saraf cranial III (Nervus Occulomotorius), Red Nukleus, dan Pedunkel, menyebabkan hemiparesis kontralateral dengan tremor di extremitas yang parese dan kelumpuhan ipsilateral occulomotorius. Defisit occulomotorius termasuk ptosis, strabismus divergen, dan dilatasi[…] [docshare.tips] Cranial Neuropathy Rheumatoid arthritis (RA) shows a variable clinical expression in patients. Articular disease is common manifestation, but patients may rarely present with extra-articular manifestation such as cranial neuropathy. Also, primary hepatic lymphoma (PHL) has rarely been reported in patient treated with immunosuppressive[…] [ncbi.nlm.nih.gov] Botulism Abstract Recent studies of patients with botulism found ophthalmoplegia as a characteristic clinical sign. Here we illustrate a very rare case of atypical foodborne botulism with multiple bilateral cranial nerve palsies sparing palsy of extraocular muscles. Therefore, the classical diagnostic pentad of botulism (dry[…] [ncbi.nlm.nih.gov] Beriberi Abstract Upper gastrointestinal tract surgery and diuretic use are 2 unrecognized causes of thiamine (vitamin B1) deficiency. Upper gastrointestinal tract surgery decreases the thiamine absorption, and diuretic use increases urinary excretion of thiamine. We present a case of a patient with a history of[…] [ncbi.nlm.nih.gov] Pyruvate Carboxylase Deficiency The ophthalmologist may describe disconjugate eye movements, decreased visual tracking and pupillary response, or frank blindness. [symptoma.com] Ophthalmologic examination may reveal poor visual tracking, grossly disconjugate eye movements, poor pupillary response, and/or blindness. [emedicine.medscape.com] Malnutrition Seesaw Nystagmus and Hemi-Seesaw Nystagmus Seesaw nystagmus, a subtype of torsional nystagmus, is descriptively named for the pendular, disconjugate movement of eyes in which [eyewiki.aao.org] The frequency is usually high, movement pendular, with a small amplitude, and disconjugated oscillations. The movements can be horizontal, vertical or torsional. [intechopen.com] Acquired Pendular Nystagmus Unlike congenital pendular nystagmus, acquired pendular nystagmus often entails slow-phase eye movements in horizontal, vertical, and torsional [eyewiki.aao.org] Oculopalatoskeletal Syndrome […] nystagmus, disconjugate eye movements Alpers’ syndrome (203700) Blindness, visual disturbances; microcephaly occasional Borjeson–Forssman–Lehmann syndrome (301900) Deep-set [clinicalgate.com] Syndrome (OMIM Number) Ophthalmologic Abnormality Aicardi–Goutières syndrome (225750) Visual inattention, abnormal eye movements Allan–Herndon–Dudley syndrome (300523) Rotary [clinicalgate.com] eye movements, optic dysplasia; microcephaly occasional Mosaic variegated aneuploidy syndrome (257300) Hypertelorism, upslanting palpebral fissures, epicanthal folds, cataracts [clinicalgate.com] Respiratory Muscle Paralysis Symptoms of myasthenia can include ptosis (eyelid drooping), disconjugate eye movements and double vision, slurred speech, difficulty chewing and swallowing, and neck, arm [myasthenia.org] Strabismus We describe a patient with ictal disconjugate contraversive horizontal eye deviation of cortical origin as the main clinical feature of a focal seizure. [ncbi.nlm.nih.gov] Ictal strabismus, sometimes associated with epileptic nystagmus, is an extremely rare epileptic phenomenon, suggestive of cortical involvement in monocular eye movement control [ncbi.nlm.nih.gov]
