Presentation
Presentation on theme: "166-26 Claude’s Syndrome. [slideplayer.com]
Lateral gaze palsy present Locked In syndrome Bilateral pontine infarction/bleed Quardiplegia, consiousness preserved Only vertical eye movements present. [masterofmedicine.com]
Case Reports Case 1 An 87-year-old male presented to us with complaints of unsteadiness of gait and double vision of 4 days duration. This was noted on waking up in the morning. [mdcan-uath.org]
Neurocysticercosis presenting as Weber’s syndrome: As short report. [neurologyindia.com]
Lesions of the third nerve fascicle can present as an isolated complete or incomplete third nerve palsy, in association with other neurologic signs due to involvement of adjacent midbrain structures. [collections.lib.utah.edu]
Entire Body System
- Gangrene
[…] acroparesthesia I73.89 ICD-10-CM Codes Adjacent To I73.89 I72.6 Aneurysm of vertebral artery I72.8 Aneurysm of other specified arteries I72.9 Aneurysm of unspecified site I73 Other peripheral vascular diseases I73.0 Raynaud's syndrome I73.00 …… without gangrene [icd10data.com]
Respiratoric
- Dyspnea
The symptoms at time of CMR were chest pain (33.3%), dyspnea (39.4%), fatigue (42.4%), and arrhythmia (6.1%), with any of the above in 57.6% of the patients. [frontiersin.org]
Skin
- Erythema
Comfort-Steinberg syndrome [医]遗传性胰腺炎综合征 Compulsive tobacco user syndrome [医]被动吸烟综合征,强迫吸烟者综合征 Congenital epiblepharon-inferior oblique syndrome [医]先天性睑赘皮-眼下斜综合征 Congenital muscular hypertrophy-cerebral syndrome [医]先天肌肥大-大脑综合征 Congenital telangiectatic erythema [fastdict.net]
Eyes
- Diplopia
Specific syndromes need to be known because of their highly localizing value (▶Table 13.6). 13.8 Treatment of Diplopia Binocular diplopia resolves when the patient closes one eye. [neuro-ophthalmology.stanford.edu]
Type your tag names separated by a space and hit enter Abstract A 72-year-old woman developed a sudden onset of bilateral ptosis, diplopia and gait disturbance. [unboundmedicine.com]
Puntos de vista 1,227 28 3 Publicado en 18.04.2019 Weber, benedikt, Claude, Nothnagel syndrome,, Tiempo de ejecución 00:02:52 Weber, benedikt, Claude, FASCICULAR LESIONS, oculomotor fascicles, oculomotor palsy, Dilated pupil, Diplopia, Ptosis, lateral [hn.vip-vlip.lv]
Either the diplopia eliminates after closing one eye (binocular diplopia) The diplopia remains after closing one eye (monocular diplopia) Monocular diplopia must not be confused with metamorphopsia secondary to maculopathy 8. [de.slideshare.net]
Abstract A 72-year-old woman developed a sudden onset of bilateral ptosis, diplopia and gait disturbance. Neurological examination revealed bilateral oculomotor palsies, truncal ataxia, and transient slight weakness in the right upper extremity. [ncbi.nlm.nih.gov]
- Anisocoria
The anisocoria remains the same in dim and bright light in simple central anisocoria, also called physiological anisocoria. [emedicine.medscape.com]
Evaluation and management of anisocoria(1) 7. Evaluation and management of a large or a small pupil(1) 8. [medicine.uiowa.edu]
Incidence of pupillary involvement, course of anisocoria and ophthalmoplegia in diabetic oculomotor nerve palsy. Indian J Ophthalmol. 2013 Jan-Feb. 61 (1):13-7. [Medline]. Jacobson DM. [medscape.com]
The vasculopathic form of a CN III palsy may produce some efferent pupillary defect in up to 20% of cases, although the pupillary involvement is generally mild (typically ≤1 mm anisocoria). [aao.org]
- Prolapse
Some clinical manifestations are characteristic for MFS, e.g., a positive wrist sign (Figure 1), tall stature, aortic dissection, mitral valve prolapse, and ectopia lentis [5]. [bmcoralhealth.biomedcentral.com]
Neurologic
- Ataxia
Nothnagel's Syndrome mainly due to neoplasms ...affecting the Midbrain tectum involving Ipsilateral or bilateral CN 3 causes Oculomotor palsies; ataxia. We finish Alll the midbrain syndromes !!!!! Hope it helps! -Medha [medicowesome.com]
"— Presentation transcript: 1 166-26 Claude’s Syndrome 2 Claude’s Syndrome Claude’s syndrome is a well-known midbrain syndrome characterized by ipsilateral oculomotor nerve palsy and contralateral cerebellar ataxia. [slideplayer.com]
Claudes Syndrome Combination of features of benedicts and Nothnagel’s syndromes. 3rd N palsy with contralateral tremor and ataxia, no hemiparesis. [masterofmedicine.com]
[…] with contralateral ataxia. [mdcan-uath.org]
Nothnagel's syndrome: Ipsilateral third nerve palsy, plus ipsilateral cerebellar ataxia due to involvement of the superior cerebellar peduncle. 4. [collections.lib.utah.edu]
- Cerebellar Ataxia
"— Presentation transcript: 1 166-26 Claude’s Syndrome 2 Claude’s Syndrome Claude’s syndrome is a well-known midbrain syndrome characterized by ipsilateral oculomotor nerve palsy and contralateral cerebellar ataxia. [slideplayer.com]
Ipsilateral 3rd nerve palsy with Contralateral cerebellar ataxia Benedicts Syndrome Due to involvement of red nucleus Ipsilateral 3rd nerve palsy with contralateral chorea,tremors, athetosis. [masterofmedicine.com]
Nothnagel syndrome (nōth′nāg″ĕl) [Carl Wilhelm Nothnagel, Ger. internist, 1841–1905] Paralysis of the oculomotor nerve combined with cerebellar ataxia resulting from a mass or stroke that affects the superior cerebellar peduncle on the same side as the [medical-dictionary.thefreedictionary.com]
- Tremor
“rubral tremor (The blue fibers being the sup. [medicowesome.com]
Claudes Syndrome Combination of features of benedicts and Nothnagel’s syndromes. 3rd N palsy with contralateral tremor and ataxia, no hemiparesis. [masterofmedicine.com]
Benedikt’s syndrome: Ipsilateral third nerve palsy, plus contralateral tremor due to involvement of the red nucleus. 13 Third Nerve Nothnagel’s syndrome: Ipsilateral third nerve palsy, plus ipsilateral cerebellar ataxia due to involvement of the superior [slideplayer.com]
Upon awakening he complained of double vision and there was a notable tremor in his left arm. There was a mildly elevated blood pressure. Mental status was good and speech was articulate and appropriate. [forums.studentdoctor.net]
- Involuntary Movements
The first, with a right hemiplegia, involuntary movements, and bilateral ophthalmoparesis, fit the definition only loosely. [docksci.com]
Transient involuntary movement of the left leg suggested that the lesion involved the red nucleus. Cranial MRI scans revealed an infarct extending from the dorsal paramedian region of the right midbrain tegmentum to the medial side of the thalamus. [pure.fujita-hu.ac.jp]
• Posterolateral infarction syndrome is characterized by contralateral pure sensory deficit, sensory motor stroke, or sensory motor deficit with abnormal involuntary movements. • Oculomotor and supranuclear (conjugate or disconjugate) vertical gaze [medlink.com]
- Chorea
Ipsilateral 3rd nerve palsy with Contralateral cerebellar ataxia Benedicts Syndrome Due to involvement of red nucleus Ipsilateral 3rd nerve palsy with contralateral chorea,tremors, athetosis. [masterofmedicine.com]
Nothnagel's syndrome is characterized by - 1) Ipsilateral III nerve palsy, contralateral tremor, chorea and athetosis 2) Ipsilateral III nerve palsy, contralateral cerebral ataxia, chorea and athetosis 3) Ipsilateral III nerve palsy with contralateral [upscgk.com]
[…] ejecución 00:02:52 Weber, benedikt, Claude, FASCICULAR LESIONS, oculomotor fascicles, oculomotor palsy, Dilated pupil, Diplopia, Ptosis, lateral rectus, midbrain syndromes, benedikt syndrome, Nothnagel syndrome, Claude syndrome, Weber syndrome, red nucleus, Chorea [hn.vip-vlip.lv]
Benedikt syndrome ventral tegmentum, PCA Parinaud's syndrome dorsal, tumor Nothnagel's syndrome Claude's syndrome Other Alternating hemiplegia Cerebellum lateral ( Dysmetria Dysdiadochokinesia Intention tremor ) medial ( Cerebellar ataxia ) Basal ganglia Chorea [en.wikipedia.org]
Huntington's Chorea b. Parkinson's Disease VIII. Cerebral Hemisphere A. Anatomy B. Lesions 1. Vascular a. Middle Cerebral Artery b. Posterior Cerebral Artery c. Anterior branches of Middle Cerebral Artery 2. Neoplasms a. Meningioma b. [lksom.temple.edu]
Workup
* Thiamine Fascicular Infarction, mass, infection, inflammation, compression Contralateral hemiparesis or tremor; pupil may be spared MR imaging Stroke resuscitation, antiplatelet therapy, coumadin Demyelination Stroke workup* Interferon-β1, Copaxone [de.slideshare.net]
A thorough workup, including neuroimaging is essential to rule out anatomic lesions or other causes of this syndrome. Visually significant upgaze palsy can be relieved with bilateral inferior rectus recessions. [ipfs.io]
But, if it doesn’t, further workup should include MRI, a vasculitis workup and CSF examination to rule out infectious diseases or overproduction anomalies (e.g., pseudotumor cerebri, hydrocephalus, aqueductal stenosis, meningitis). [reviewofoptometry.com]
Nevertheless, basic workup must be done. [eyewiki.aao.org]
Treatment
This is an acceptable temporary treatment, either until the diplopia resolves by itself or until other treatments are decided on. Many simple, common sense measures can improve the vision of diplopic patients. [neuro-ophthalmology.stanford.edu]
In such cases, it is necessary to assess the treatment priority for each impairment adequately. [jstage.jst.go.jp]
The patient improved and became asymptomatic with steroid treatment. Recognizing this clinical entity would avoid unnecessary antituberculous treatment and surgical intervention. How to cite this article: Singh N N, Verma R, Pankaj B K, Misra S. [neurologyindia.com]
Prognosis
Therefore studies on prognosis of silent ischemia are of great importance, as their results should indicate how aggressively patients are to be managed. [books.google.com]
Prognosis is poor with a median survival of 6-9 years. The documents contained in this web site are presented for information purposes only. [orpha.net]
Subject Heading(Keyword) Nothnagel syndrome Subject Heading(Keyword) リハビリテーション Subject Heading(Keyword) rehabilitation Subject Heading(Keyword) 注意障害 Subject Heading(Keyword) inattention Subject Heading(Keyword) 機能予後 Subject Heading(Keyword) functional prognosis [iss.ndl.go.jp]
Prognosis and treatment The eye findings of Parinaud's Syndrome generally improve slowly over months, especially with resolution of the causative factor; continued resolution after the first 3–6 months of onset is uncommon. [ipfs.io]
Causes and prognosis in 4,278 cases of paralysis of the oculomotor, trochlear, and abducens cranial nerves.Am J Ophthalmol. 1992;113(5):489–496. [aao.org]
Etiology
Etiology Midbrain Infarct Disease/Diagnosis Fascicular third nerve palsy; Contralateral limb ataxia; Midbrain infart; Claude's syndrome References 1. Akdal G, Kutluk K, Men S, Yaka E. [collections.lib.utah.edu]
• Small vessel disease is the prime etiology in thalamic infarcts. • The etiology of midbrain infarcts remains undetermined in up to 50% of cases. [medlink.com]
The most common known etiology is a posterior communicating artery aneurysm. This is a medical emergency. [eyewiki.aao.org]
Epidemiology
Summary Epidemiology Prevalence ranges from 1/50,000-1/20,000. MSA-parkinsonian type (MSA-p) predominates in the Western Hemisphere and MSA-cerebellar type (MSA-c) predominates in the Eastern Hemisphere. Genders are equally distributed. [orpha.net]
Epidemiology of Parinaud’s syndrome The disease is most prevalent among young patients with brain tumours in the pineal gland or midbrain: pinealomas (intracranial gernomas) are the most common lesion producing this syndrome. [emergency-live.com]
[…] years after the initial symptoms appeared. [5] However, more than 85% of patients have seen minimal symptoms present at six months from the time of the original stroke, and have been able to independently accomplish average daily within a year. [6] Epidemiology [en.wikipedia.org]
Sex differences in stroke epidemiology: a systematic review. Stroke. 2009; 40 (4). doi: 10.1161/STROKEAHA.108.540781. | Open in Read by QxMD Ariesen MJ, Claus SP, Rinkel GJ, Algra A. [amboss.com]
Deep vein thrombosis of the axillary-subclavian veins: Epidemiologic data, effects of different types of treatment and late sequelae. Eur J Vasc Surg 1988; 2: 161–165. Google Scholar | Crossref | Medline 10. Tilney, ML, Griffiths, HJ, Edwards, EA. [journals.sagepub.com]
Pathophysiology
In an early experimental study on rabbits conducted in 1876, he demonstrated the involvement of the vermis in the pathophysiology of motor ataxia. [unboundmedicine.com]
To approach this question, a deeper look has to be taken into the pathophysiology of cardiac pain and the excitatory and inhibitory mechanisms involved. [books.google.com]
Medicine, Biology Cerebellum 2022 The internist Hermann Nothnagel (1841-1905) took a special interest in the cerebellum and demonstrated the involvement of the vermis in the pathophysiology of motor ataxia, culminating in the Cerebellar Classic highlighted [semanticscholar.org]
However, the pathophysiology related to these signs is mainly unknown and poorly described in the literature. [mdpi.com]
Prevention
Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. [books.google.es]
A randomized trial of permanent cardiac pacing for the prevention of vasovagal syncope. J Am Coll Cardiol 1999; 33:16–20 PubMed Google Scholar 11. Benditt DG. Cardiac pacing for prevention of vasovagal syncope. J Am Coll Cardiol 1999; 33:21–23. [link.springer.com]
In this article, the authors present in depth the clinical correlates of midbrain and thalamic ischemic lesions, while also summarizing the advances in treatment and prevention of ischemic lesions involving the different vascular territories of the thalamus [medlink.com]
A trained first responder who can immediately stabilize the patient and prevent the deterioration is critical. [statpearls.com]