ISSN:1070-8022    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1070-8022    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Abstract: ObjectivesWe sought to evaluate the effect of hyperthermia (HT) on central conduction pathways by alterations in pattern visual evoked potentials (PVEPs) in normal and demyelinated optic nerves.Materials and MethodsWe studied PVEP peak latency and amplitudes in 10 normal subjects and six patients with demyelinating optic neuropathy before and during HT.ResultsIn normal subjects, a mean rise in temperature of 2.5°C resulted in a decrease in the second positive peak (P2) latency of 6.1 ms (p < 0.0001) and a slight decline in P2 amplitude of 1.16 μV (p < 0.009). These results were compared to those obtained from six patients with multiple sclerosis. These patients had a history of monocular optic neuritis; two patients had had bilateral optic neuritis, and one patient had not had involvement of the optic nerve. Average temperature elevations during PVEPs were 1.60°C. PVEPs among these patients showed decrease in mean P2 latencies, except in patients with multiple sclerosis, who showed an increase in latency with 60 min check size in the left eyes. There was a consistent decline in P2 amplitudes. Loss of amplitude was greater among the six optic nerves of those patients having transient, mild losses in visual acuity during HT. Reductions in P2 amplitude were best explained by partial or complete conduction block.ConclusionsThese changes in conduction time and amplitude during HT provide a neurophysiologic correlation to the well-known sensitivity of demyelinated optic nerves to elevated temperatures. They are also relevant to the monitoring of central pathways in the operative or intensive care setting. The demonstrated reversible loss of amplitudes also gives promise to therapeutic manipulation of impaired pathways by impeding the loss of current from denuded nerve fibers.

ISSN:1070-8022    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1070-8022    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

We describe seven cases of dysthyroid orbitopathy initially seen as severe periocular lid swelling. Imaging techniques typically demonstrate normal extraocular muscles, although moderate muscle enlargement may occur. Patients do not respond to steroids, radiation therapy, antihistamines, or diuretics. We believe this clinical picture represents a unique population of dysthyroid orbitopathy patients who are best managed by long-term observation followed by cosmetic surgery.

ISSN:1070-8022    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Abstract:IntroductionThe mechanism(s) underlying the eye pain syndrome characterized by photo-oculodynia and decreased tears (herein referred to as PODS) is unknown. Postulating a sympathetically maintained pain mechanism, cervical sympathetic ganglion blocks (CSB) were performed in an open-label trial in two patients as a pilot test of our hypothesis. Because these patients experienced clinically dramatic reductions in signs and symptoms, a double-masked controlled trial was initiated.MethodsWith Institutional Review Board approval and written informed consent, four other subjects with PODS who had experienced temporary reduction (>50%) of symptoms with a single lidocaine CSB were enrolled. A randomized, double-masked series of three CSBs (saline, bupivacaine, lidocaine) was scheduled for each subject 2–7 days apart.ResultsCSB with lidocaine and bupivicaine, but not saline, reduced spontaneous pain and light sensitivity and increased production of tears. Symptom reduction lasted for hours to days, extending beyond clinical signs of local anesthetic-induced sympatholysis. It was also observed that sympatholysis extinguished associated blepharospasm in those subjects with this dystonic condition (one subject in the open-label pilot trial and two of three in the controlled trial).ConclusionsResults of these preliminary data suggest that the sympathetic nervous system is involved in mediating symptoms associated with PODS in certain individuals.

ISSN:1070-8022    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

A patient with a coup de sabre lesion of the forehead developed progressive ipsilateral limitation of ocular motility, primarily involving adduction and depression. Investigation disclosed no other explanation for the ocular motility disturbance, which we suspect represents restrictive myopathy maximally involving ocular muscles immediately subjacent to the area of linear scleroderma.

ISSN:1070-8022    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Progressive, painful ophthalmoplegia developed in a 34-year-old man. MRI scan revealed an enhancing mass in the left cavernous sinus. Histologic examination of resected tumor revealed reticulin staining and cytologic features of hemangiopericytoma. Characteristics of intracranial hemangiopericytoma are reviewed.

ISSN:1070-8022    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

We report a case of alexia without either agraphia or hemianopia following herpes simplex encephalitis. The patient had a temporal lobe lesion with involvement of the occipitotemporal gyrus. This is an unusual cause of alexia without agraphia. The location of the lesion supports the view that transcallosal fibers from the right hemisphere to the left angular gyrus course inferior to the posterior horn of the left lateral ventricle and pass close to the left occipitotemporal gyrus.

ISSN:1070-8022    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Isolated third-nerve palsies are seen most commonly with aneurysms, vascular disease, trauma, or neoplasms (1–5). Sinus mucoceles have been known to cause orbital symptoms including proptosis and cranial nerve palsies. Rarely, an oculomotor nerve abnormality may be seen in the setting of mucoceles of the paranasal sinuses. We describe an unusual case of an isolated pupil-sparing third-nerve palsy as the presenting sign of a frontal sinus mucocele. Emphasis is placed on the discussion of sinus mucoceles and their relation to orbital symptoms.

ISSN:1070-8022    

出版商:OVID    

年代:1995

数据来源: OVID