Oculomotor nerve damage in this area can produce varied presentations. [eyewiki.aao.org]

We present a case of brainstem midbrain syndrome caused by ischemic stroke. The male hypertensive diabetic patient presented with sudden onset of diplopia, ptosis and gait imbalance. [banglajol.info]

Pain may or may not be present; if present, it may be quite severe in some patients. Therefore, pain does not distinguish ischemia from aneurysmal compression. [aao.org]

Clinical presentation Classically, the syndrome involves the oculomotor nerve fascicles and superior cerebellar peduncle, leading to ipsilateral CN III palsy and limb ataxia respectively. [pacs.de]

We report on a 68-year-old man who presented with typical Nothnagel's syndrome. Neurological examinations revealed a left cerebellar ataxia associated with oculomotor and trochlear palsies and an eccentric and oval pupil in the right eye. [pure.fujita-hu.ac.jp]

• 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]

• Plethora

  Hathout Medicine American Journal of Neuroradiology 2009 Among the plethora of case review publications, Clinical Neuroradiology: A Case-Based Approach stands out in concept, content, and educational value. [semanticscholar.org]

• Hyperacusis

  It results in a lower-motor-neuron facial nerve palsy proximal to the geniculate ganglion and hence causes loss of taste sensation in the anterior two-thirds of the tongue, hyperacusis, diplopia, and horizontal conjugate gaze palsy (21,22). [pubs.rsna.org]

  […] ipsilateral Horner's syndrome, ipsilateral facial loss of pain & temperature, ipsilateral palsy of soft palate, larynx & pharynx, ipsilateral cerebellar hemi-ataxia, contralateral loss of body pain & temperature, nystagmus, dysarthria, dysphagia, and hyperacusis [statpearls.com]

• Ataxia

  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]

  Neurological examinations revealed a left cerebellar ataxia associated with oculomotor and trochlear palsies and an eccentric and oval pupil in the right eye. There was a vertical and lateral gaze paresis in the left eye. [pure.fujita-hu.ac.jp]

  […] with contralateral ataxia. [mdcan-uath.org]

• Cerebellar Ataxia

  Neurological examinations revealed a left cerebellar ataxia associated with oculomotor and trochlear palsies and an eccentric and oval pupil in the right eye. There was a vertical and lateral gaze paresis in the left eye. [pure.fujita-hu.ac.jp]

  Medical Dictionary for the Health Professions and Nursing © Farlex 2012 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 [medical-dictionary.thefreedictionary.com]

  Its major signs are unilateral oculomotor nerve paralysis and ipsilateral cerebellar ataxia. [lksom.temple.edu]

  ataxia, PCA, dysdiadochokinesia, cerebral peduncle, corticospinal, corticobulbar tract, Spastic hemiplegia, Babinski, upper motor neuron lesion, USMLE, MRCP, [hn.vip-vlip.lv]

• Recurrent Headache

  The third edition of The International Classification of Headache Disorders (ICHD) recently introduced recurrent painful oculomotor neuropathy as the new classification for recurrent headaches with subsequent unilateral ophthalmoplegia, replacing the [aao.org]

• Fluctuating Level of Consciousness

  The main clinical manifestations consist of fluctuating levels of consciousness, abulia, apathy, disorientation, lack of insight and personality changes, contralateral emotional-facial paresis, occasional hemiparesis, and visual field deficits. [neupsykey.com]

* 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. [en.wikipedia.org]

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 is recommended. This may include the following: vital signs (e.g. blood pressure), complete blood count (CBC), sedimentation rate (ESR), C-reactive protein (CRP) comprehensive metabolic panel (CMP). [eyewiki.aao.org]

• Xanthochromia

  When neuroimaging appears normal, lumbar puncture may yield evidence of a subarachnoid hemorrhage (xanthochromia of the spinal fluid) or detect an inflammatory or neoplastic cause. [aao.org]

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]

Treatment for Parinaud’s syndrome Treatment is mainly directed at the upstream cause of the dorsal midbrain lesion. A thorough examination, including neuroimaging, is essential to exclude anatomical lesions or other causes of this syndrome. [emergency-live.com]

In such cases, it is necessary to assess the treatment priority for each impairment adequately. [pesquisa.bvsalud.org]

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]

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]

Prognosis Ocular function in patients with Parinaud’s syndrome generally improves slowly over months, especially with resolution of the upstream causative factor, although this is not always possible as some lesions result in permanent nerve damage; continuous [emergency-live.com]

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[edit] 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. [en.wikipedia.org]

The most common known etiology is a posterior communicating artery aneurysm. This is a medical emergency. [eyewiki.aao.org]

The etiology is an absolute deficiency of thiamine rather than a direct toxic effect of… [semanticscholar.org]

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]

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]

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]

Stroke. 1988 Sep; [PubMed PMID: 3413804] [7] Guzik A,Bushnell C, Stroke Epidemiology and Risk Factor Management. Continuum (Minneapolis, Minn.). 2017 Feb; [PubMed PMID: 28157742] [8] Kaji R, Global burden of neurological diseases highlights stroke. [statpearls.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]

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]

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]

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]

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]

China has the most significant lifetime estimated risk of 39.3%.[10] Pathophysiology The pathophysiology of all infarcts is the lack of oxygen in the tissue, leading to its death. [statpearls.com]

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]

A trained first responder who can immediately stabilize the patient and prevent the deterioration is critical. [statpearls.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]