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Show 52 LITERATURE ABSTRACTS is of a 55-year-old diabetic woman who had a 3 em segment of the right superficial temporal artery resected and postoperatively developed a marked brow droop from right frontalis dysfunction. Presumably, upper temporal branches of the facial nerve were traumatized during the biopsy. The patient had 70% improvement in frontalis function within 6 months. Lyn A. Sedwick, M.D. Abnormal Spatial Localization in Patients with Herpes Zoster Ophthalmicus. Campos EC, Chiesi C, Bolzani D. Arch Ophtha/mo/ 1986;104:1176-7 (Aug). [Reprint requests to Emilio C. Campos, M.D., Clinica Oculistica dell'Universita, Via del Pozzo, 71, Modena, Italy.] This short article describes errors in spatial localization made by the ipsilateral eye in patients with acute herpes zoster ophthalmicus, compared to localization by the unaffected eye. In five of six patients, there was remarkable inability to point to targets accurately (the patients could not see their pointing hand), with both past pointing and short pointing observed. Each patient had one side to which the degree of error increased, but not consistently with the eye involved, e.g., some right eyes involved had increased errors with targets to the left of center and some with targets to the right of center. No patient had a frank ocular motility disturbance, and 2 months later the localization ability returned to normal in the ipsilateral eye. The authors postulate that information about proprioception is carried by the trigeminal nerve from the extraocular muscles and that this information can alter spatial localization in the absence of strabismus. They also speculate that an adaptation to this condition may occur, allowing these patients to regain appropriate localization after 2 months. In interesting editorial comments on page 1148 of the same journal, Martin Steinback, Ph.D., tries to relate this study to difficulties in predicting the outcome of strabismus surgery or treatment with botulism. Lyn A. Sedwick, M.D. Brown Tumor of the Orbit. Parrish CM, O'Day OM. Arch Ophtha/mol 1986;104:1199-202 (Aug). r·r<;,~; to Ca.rolyn M. Parrish, M.D., Department of Ophthalmology, Vanderbilt University Medical Center, Medical Center North 05200, Nashville, TN 37232.] A 7-year-old girl with chronic renal failure presented with lethargy and eye rubbing. Her physical examination was remarkable for poor vision (hand motion 0.0., light perception O.S.), marked abduction deficits O.U., and bilateral disc edema. WorkUp disclosed a mass in the right maxillary antrum that was contiguous with a second mass in the sphenoid bone; this second mass filled the ethmoids and extruded laterally into the posterior orbit on both sides, with deviation of medial rectus and optic nerves. Surgery revealed a dark brown soft mass with fibrous and giant cell proliferation, and osseous metaplasia and osteoclastic activity consistent with a brown tumor. The authors note that such tumors are frequently seen with primary hyperparathyroidism, rarely seen with secondary parathyroidism (as in this case), and rarely found in the orbit, according to the literature. Their case is also unusual in its presentation with decreased vision and motility deficits since proptosis and nasal obstruction are more commonly the presenting complaints. Lyn A. Sedwick, M.D. Intermittent Pupillary Dilation in a Young Woman. Miller NR. With comments by JL Keltner, JW Gittinger, and RM Burde. Surv Ophtha/mol 1986;31:65-8 (July-Aug). [Reprints not available.] A 28-year-old woman with a history of rightsided headaches, sometimes associated with dilation of the right pupil, is discussed. Drs. Keltner, Gittinger, and Burde agree that this patient has a form of migraine. All three discuss the possible etiologies of the pupillary dilation and note that unilateral pupillary dilation without other signs or symptoms of third nerve dysfunction is vanishingly rare as a manifestation of aneurysmal compression of the third nerve. These discussants advise against investigation for an aneurysm in this and similar patients. Lyn A. Sedwick, M.D. Oral Acyclovir in the Treatment of Acute Herpes Zoster Ophthalmicus. Cobo LM, Foulks GN, |
