Tell-Tale Third

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Identifier walsh_2003_s1_c1
Title Tell-Tale Third
Creator M. Tariq Bhatti, MD, Duke Health
Subject Blepharoptosis; Anisocoria; Ophthalmoplegia; Oculomotor Nerve Diseases; Abducens Nerve Diseases; Multiple Sclerosis
History A 30-year old female with a 1-day history of binocular diplopia associated with pain over the left eyebrow.
Pathology White matter demyelinating lesions of the spinal cord
Disease/Diagnosis Multiple Sclerosis
Clinical VA: 20/20 OU declining to 20/400; RAPD OS
Presenting Symptom Diplopia; Pain over left eyebrow
Neuroimaging MRI
Treatment Corticosteroids
Date 2003
References 1. Thomke F, Lensch E, Ringel K, Hopf HC. Isolated cranial nerve palsies in multiple sclerosis. J Neurol Neurosurg Psychiatry 1997; 63:682-5. 2. Richards BW, Jones FR, Jr., Younge BR. Causes and prognosis in 4,278 cases of paralysis of the oculomotor, trochlear, and abducens cranial nerves. Am J Ophthalmol 1992; 113:489-96. 3. Jacobson DM, Moster ML, Eggenberger ER, Galetta SL, Liu GT. Isolated trochlear nerve palsy in patients with multiple sclerosis. Neurology 1999; 53:877-9. 4. Rush JA, Younge BR. Paralysis of cranial nerves III, IV, and VI. Cause and prognosis in 1,000 cases. Arch Ophthalmol 1981; 99:76-9. 5. Desai HB, MacFadyen DJ. Multiple sclerosis presenting as third nerve palsy. Can J Neurol Sci 1987; 14:178-9. 6. Galer BS, Lipton RB, Weinstein S, Bello L, Solomon S. Apoplectic headache and oculomotor nerve palsy: an unusual presentation of multiple sclerosis. Neurology 1990; 40:1465-6. 7. Ksiazek SM, Repka MX, Maguire A, et al. Divisional oculomotor nerve paresis caused by intrinsic brainstem disease. Ann Neurol 1989; 26:714-8. 8. Newman NJ, Lessell S. Isolated pupil-sparing third-nerve palsy as the presenting sign of multiple sclerosis. Arch Neurol 1990; 47:817-8. 9. Uitti RJ, Rajput AH. Multiple sclerosis presenting as isolated oculomotor nerve palsy. Can J Neurol Sci 1986; 13:270-2. 10. Bentley PI, Kimber T, Schapira AH. Painful third nerve palsy in MS. Neurology 2002; 58:1532. 11. Lee AG, Tang RA, Wong GG, Schiffman JS, Singh S. Isolated inferior rectus muscle palsy resulting from a nuclear third nerve lesion as the initial manifestation of multiple sclerosis. J Neuroophthalmol 2000; 20:246-7. 12. Mark AS, Blake P, Atlas SW, Ross M, Brown D, Kolsky M. Gd-DTPA enhancement of the cisternal portion of the oculomotor nerve on MR imaging. Am J Neuroradiol 1992; 13:1463-70. 13. Blake PY, Mark AS, Kattah J, Kolsky M. MR of oculomotor nerve palsy. Am J Neuroradiol 1995; 16:1665-72. 14. Kalman B, Lublin FD. Spectrum and classification of inflammatory demyelinating diseases of the central nervous system. Curr Neurol Neurosci Rep 2001; 1:249-56. 15. Poser CM. The peripheral nervous system in multiple sclerosis. A review and pathogenetic hypothesis. J Neurol Sci 1987; 79:83-90. 16. Feasby TE. Inflammatory-demyelinating polyneuropathies. Neurol Clin 1992; 10:651-70. 17. Mendell JR, Kolkin S, Kissel JT, Weiss KL, Chakeres DW, Rammohan KW. Evidence for central nervous system demyelination in chronic inflammatory demyelinating polyradiculoneuropathy. Neurology 1987; 37:1291-4. 18. Feasby TE, Hahn AF, Koopman WJ, Lee DH. Central lesions in chronic inflammatory demyelinating polyneuropathy: an MRI study. Neurology 1990; 40:476-8. 19. McDonald WI, Compston A, Edan G, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 2001; 50:121-7. 20. Pareyson D, Ciano C, Fiacchino F, Gemma M, Savoiardo M, Sghirlanzoni A. Combined central and peripheral acute demyelination. Ital J Neurol Sci 1993; 14:83-6. 21. Schoene WC, Carpenter S, Behan PO, Geschwind N. 'Onion bulb' formations in the central and peripheral nervous system in association with multiple sclerosis and hypertrophic polyneuropathy. Brain 1977; 100:755-73. 22. Berger T, Weerth S, Kojima K, Linington C, Wekerle H, Lassmann H. Experimental autoimmune encephalomyelitis: the antigen specificity of T lymphocytes determines the topography of lesions in the central and peripheral nervous system. Lab Invest 1997; 76:355-64.
Language eng
Format application/pdf
Type Text
Source 29th Annual North American Neuro-Ophthalmology Society Meeting, Frank B. Walsh Session CD-ROM
Relation is Part of Case 1, Session I, Walsh Session, NANOS 2003
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
Rights Management Copyright 2008. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6s1856s
Contributor Primary Bhatti M.Tariq
Setname ehsl_novel_fbw
ID 177627
Reference URL https://collections.lib.utah.edu/ark:/87278/s6s1856s
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