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Congenital Fibrosis of Extraocular Muscles

Tolosa-Hunt Syndrome


Presentation

  • Binocular vision is often present. The familial and hereditary pattern so often present in the general fibrosis syndrome is rarely encountered.[healio.com]
  • A 17-year-old boy presented with a large exotropia with both eyes fixed in an abduction and upgaze, pupillary involvement since childhood.[ncbi.nlm.nih.gov]
  • Four contiguous, 1-mm-thick MRI oblique axial image planes, obtained with heavy T 2 -weighting, are presented in rostral-to-caudal sequence. F igure 4.[iovs.arvojournals.org]
Amyloidosis
  • A case was reported in which the strabismus fixus was due to amyloidosis 23.[geocities.ws]
Inguinal Hernia
  • Some of the associated systemic anomalies reported are benign ethmoidal mesenchymoma, bilateral inguinal hernias. Unilateral cases of CFEOM may show facial asymmetry with the affected side of the face being smaller. Orbital anomalies may be present.[geocities.ws]
Heart Disease
  • Other ocular manifestations such as astigmatism, amblyopia and nystagmus; and systemic manifestations such as cranio-facial dysmorphism, dental anomalies, syringomyelia, spina bifida and congenital heart disease, were also described in association with[jpgmonline.com]
Cardiomegaly
  • The patient's father possibly had Noonan syndrome as he had a short-neck, sensorineural deafness and cardiomegaly. She also had a sister that had similar facial features and pulmonary stenosis, and died at the age of 19.[jpgmonline.com]
Blurred Vision
  • . :: Case History A 32-year-old female presented to the eye casualty with blurred vision and photophobia of the left eye.[jpgmonline.com]
Photophobia
  • . :: Case History A 32-year-old female presented to the eye casualty with blurred vision and photophobia of the left eye.[jpgmonline.com]
Short Arm
  • Localization of a gene which complements branched-chain amino acid transaminase deficiency to the short arm of human chromosome 12. Hum.[nature.com]
Short Neck
  • She had been diagnosed clinically to have Noonan syndrome several years before and showed features consistent with that syndrome including short stature and short neck [Figure - 1].[jpgmonline.com]
Rotary Nystagmus
  • There also was right exotropia and an intermittent mixed horizontal and rotary nystagmus.[jpgmonline.com]
Pendular Nystagmus
  • 3'27; ventricular septal defect 2I ; anomalous posterior tendonous insertions and an absence of the lateral rectus "; choroidal coloboma and secondary fibrous bands l; pendular nystagmus and bilateral optic disc hypoplasia (Case No. 7); and talipes equinovalgus[healio.com]

Workup

HLA-B27
  • HLA-B27 was positive but none of the autoimmune markers was positivie. Other routine blood and biochemical investigations were normal.[jpgmonline.com]

Treatment

  • This approach will enable the practitioner to make the most accurate diagnosis and choose the most effective treatment option.[books.google.de]
  • The surgery of both extraocular muscles and ptosis led to a fair outcome in mother even 30 years after, and a very good outcome in daughter 4 years after the treatment.[ncbi.nlm.nih.gov]
  • Early treatment is important because of the risk of amblyopia. Surgery is the primary treatment option for strabismus and blepharoptosis.[ingentaconnect.com]
  • Treatment Treatment Options: Normal ocular movements cannot be restored but large recessions of the inferior recti followed by frontalis suspension of the upper eyelids can improve severe ptosis and the compensatory chin-up gaze.[disorders.eyes.arizona.edu]
  • Upon diagnosis, treatment may be provided that include prescription eyeglasses and surgical procedures, as necessary The prognosis of Congenital Fibrosis of the Extraocular Muscles depends on the severity of the signs symptoms.[dovemed.com]

Prognosis

  • Upon diagnosis, treatment may be provided that include prescription eyeglasses and surgical procedures, as necessary The prognosis of Congenital Fibrosis of the Extraocular Muscles depends on the severity of the signs symptoms.[dovemed.com]
  • The visual prognosis depends on the treatment of amblyopia. A timely referral to ophthalmology is necessary to begin treatment. If the lid occludes the pupil, the referral is urgent to prevent dense vision loss.[clinicaladvisor.com]
  • BMJ 345:8497 CrossRef Google Scholar Spillane J, Hirsch NP, Kullmann DM, Taylor C, Howard RS (2014) Myasthenia gravis ‐ treatment of acute severe exacerbations in the intensive care unit results in a favourable long‐term prognosis.[link.springer.com]

Etiology

  • , Mark; Matsumoto, Naomichi; Saito, Nakamichi; Louise Z Collins, Mary; Morris, Lisa; Monte, Del M; Magli, Adriano; de Berardinis, Teresa 2002-03-06 Citation: BMC Genetics. 2002 Mar 06;3(1):3 Abstract: Abstract Background To learn about the molecular etiology[deepblue.lib.umich.edu]
  • (Etiology) There are 4 forms of Congenital Fibrosis of the Extraocular Muscles and the nature of their cause is described below: CFEOM type 1 and type 3 are caused by the inheritance of specific autosomal dominant genes.[dovemed.com]
  • The pathophysiology of this disorder is unknown and it is unclear if it has a primary neurogenic or myopathic etiology. We report linkage of this disorder, in two unrelated families, to markers in the pericentromeric region of human chromosome 12.[nature.com]
  • While CFEOM syndromes was classically thought to be due to a congenital abnormality of muscle development, I is now considered to have a neurologic etiology and the term congenital Cranial dysinnervation disorders (CCDD) was coined to encompass not just[meajo.org]
  • Mobius’ syndrome: features and etiology. J Pediatr Ophthalmol Strabismus 1998;35(6):304-11; quiz 327-8. 24. D’Cruz OF, Swisher CN, Jaradeh S, Tang T, Konkol RJ. Mobius syndrome: evidence for a vascular etiology. J Child Neurol 1993;8(3):260-5. 25.[neuroophthalmology.ca]

Epidemiology

  • Relevant External Links for PHOX2A Genetic Association Database (GAD) PHOX2A Human Genome Epidemiology (HuGE) Navigator PHOX2A Atlas of Genetics and Cytogenetics in Oncology and Haematology: PHOX2A No data available for Genatlas for PHOX2A Gene Sudden[genecards.org]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of this disorder is unknown and it is unclear if it has a primary neurogenic or myopathic etiology. We report linkage of this disorder, in two unrelated families, to markers in the pericentromeric region of human chromosome 12.[nature.com]
  • Semin Neurol 24:155–163 PubMed CrossRef Google Scholar Dalakas MC (2013) Pathophysiology of autoimmune polyneuropathies.[link.springer.com]

Prevention

  • 193 Scleral Complications 1931 Grey Spot 195 1932 Scleral Ridge 196 1934 Scleritis 1935 Agyrosis 194 Anterior SegmentIntraocular Complications References 200 Anterior Segment Ischemia 201 Blood Supply of the Anterior Segment 202 203 Risk Factors and Prevention[books.google.de]
  • Congenital fibrosis of the extraocular muscles prevents the normal development and function of these muscles. As a result, affected individuals are unable to move their eyes normally.[ghr.nlm.nih.gov]
  • They also scoff at any idea fake rolex that natural alternatives will help or prevent seizures. They will not teach you how to control seizures naturally. He also made it sound like it was impossible to control seizures naturally..[nrs-law.com]
  • Resources March of Dimes Birth Defects Foundation 1275 Mamaroneck Avenue White Plains, NY 10605 Tel: (914)997-4488 Fax: (914)997-4763 Internet: Prevent Blindness America 211 West Wacker Drive Suite 1700 Chicago, IL 60606 Tel: (312)363-6001 Fax: (312)363[metrohealth.net]

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