Presentation
Perhaps it is only an occasional presentation of another rather poorly understood syndrome, that of "recurrent cranial neuropathies." The present patient had at least three episodes of painful ophthalmoplegia prior to this hospitalization. [ncbi.nlm.nih.gov]
Entire Body System
- Sulfur Granules
These tests demonstrated acute inflammation and sulfur granules, which responded clinically and radiologically to parenterally administered penicillin therapy. [ncbi.nlm.nih.gov]
Jaw & Teeth
- Jaw Claudication
He hasn’t experienced headache, temple pain, jaw claudication, or fever, and there are no other neurological symptoms, such as extremity numbness, weakness, or slurred speech. He denies any recent trauma. [acepnow.com]
systemic vasculitis characterized by focal nonnecrotizing granulomatous inflammation of small to medium-sized arteries, particularly the cranial arteries arising from the aortic arch average age of 70 years PRESENTATION, GENERAL:headache, jaw [slideshare.net]
Eyes
- Corneal Edema
Proptosis Venous engorgement Sensory loss/ Periorbital pain V cranial nerve Corneal ulcers Corneal exposure due to proptosis Complete ophthalmoplegia CN III, IV, VI Decreased visual acuity or blindness Central retinal artery/ vein occlusion secondary [slideshare.net]
Face, Head & Neck
- Sinus Pain
sinus, Painful ophthalmoplegia, Tolosa-Hunt syndrome", author = "M. [moh-it.pure.elsevier.com]
Neurologic
- Pyramidal Tract Signs
However, during his hospitalization he developed involvement of cranial nerves II, III, V, VI and VII, papilledema, pyramidal tract signs and severe psychiatric disturbances, all of which remitted. [ncbi.nlm.nih.gov]
Workup
A metastatic workup was performed without any evidence of extraorbital tumor. The patient was recommended to be treated with chemotherapy, however, refused to take the treatment. The patient died of progression of the disease in a month. [ncbi.nlm.nih.gov]
Blood and CSF workup were normal. Urgent CT angiography excluded an intracerebral aneurysm and cavernous sinus thrombosis. A repeat MRI was performed, obtaining the images below. Figure 1. MRI of the brain (A=axial view. B=coronal view). [nzma.org.nz]
Ethan Sterk He is admitted to the neurology service, and subsequent workup includes the following tests: erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, antineutrophil cytoplasmic antibody, rapid plasma reagin, double-stranded [acepnow.com]
For any patient who develops signs of aberrant regeneration, workup for a structural lesion is initiated, or repeated if previous workup has been carried out and no lesion found. Nonisolated Cranial Neuropathies MULTIPLE CRANIAL NEUROPATHIES. [medtextfree.wordpress.com]
However, all recruited patients had ancillary laboratory workup, cranial MR imaging, and cerebral vascular investigation. [bmcneurol.biomedcentral.com]
X-Ray
- Sinus Opacification
Hirtz incidences revealed contralateral cavernous sinus opacification and venous drainage through the coronary sinus. These neuradiological findings helped to differentiate this syndrome from other affections which have similar signs and symptoms. [ncbi.nlm.nih.gov]
Microbiology
- Aspergillus Niger
A case of painful ophthalmoplegia due to invasive aspergillosis caused by Aspergillus niger in a diabetic patient is presented. [ncbi.nlm.nih.gov]
- Treponema Pallidum
pallidum Mycobacterial Mycobacterium tuberculosis Others Sarcoidosis Wegener's granulomatosis Eosinophilic granuloma Tolosa-Hunt syndrome Orbital pseudotumor Miscellaneous Diabetic ophthalmoplegia Ophthalmoplegic migraine Giant cell arteritis Enhancing [ncbi.nlm.nih.gov]
Treatment
MRI and positive response to the treatment with corticosteroids were relevant for making the diagnosis. [ncbi.nlm.nih.gov]
While corticoids are the treatment of reference, corticodependence and corticoresistance are frequent, hence radiotherapy has been proposed as an alternative treatment. [doi.org]
5,9 inflammatory myofibroblastic tumor (IMT) 6 idiopathic hypertrophic pachymeningitis (IHP) 6 Treatment and prognosis The condition is often successfully amenable to steroid treatment. [radiopaedia.org]
Prognosis
Individuals usually have a very good prognosis with the condition, because steroids have been proven to be an effective treatment measure Nevertheless, complications, such as the damage and abnormal repair of the cranial nerves, can worsen the prognosis [dovemed.com]
Its recognition is important since the response to steroids, although not specific, is rapid in most patients, and the prognosis for complete recovery is relatively good. [ncbi.nlm.nih.gov]
[edit] The prognosis of THS is usually considered good. [en.wikipedia.org]
Etiology
The etiological differential diagnosis of painful ophthalmoplegia is extensive and consists of numerous sinister etiologies including vascular (eg, aneurysm, carotid dissection, carotid-cavernous fistula), neoplasms (eg, primary intracranial tumors, local [ncbi.nlm.nih.gov]
Pain/etiology Abstract Progressive, painful ophthalmoplegia developed in a 34-year-old man. [collections.lib.utah.edu]
Epidemiology
Patients usually respond to corticosteroids, and spontaneous remission can occur, although movement of ocular muscles may remain damaged.[3] Roughly 30–40% of patients who are treated for THS experience a relapse.[3] Epidemiology[edit] THS is uncommon [en.wikipedia.org]
Epidemiology Frequency Tolosa-Hunt syndrome (THS) is uncommon in both the United States and internationally. The disorder is rare during the first 2 decades of life; in people older than 20 years, it appears to have an even distribution. [emedicine.com]
Pathophysiology
Pathophysiology Nonspecific inflammation (noncaseating granulomatous or nongranulomatous) within the cavernous sinus or superior orbital fissure is the cause of the constant pain, which characterizes the onset of this disorder. [emedicine.com]
One of the pathophysiologic hypothesis for the cause of ocular complications is intravenous injection of the local anaesthetic fluid.6,8,9 During anaesthesia for maxillary tooth procedures, improper size and placement of the needle can cause damage to [docksci.com]
Prevention
This case highlights the importance for the Emergency Physician to quickly recognize painful ophthalmoplegia and rapidly elucidate the cause to prevent further complications for the patient. [ncbi.nlm.nih.gov]
prevention, prognosis, and additional useful information HERE. [dovemed.com]
Feeling very tired MIGRAINE prevention Knowing the symptoms and triggers, and noting the patterns can help prevent a migraine. Sa mga ladies, halimbawa, if it usually happens before the menstrual period, alamin kung may iba pang triggers. [pep.ph]
Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. [books.google.de]