Bilateral Ptosis with Pupil Sparing Because of a Discrete Midbrain Lesion

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Title Journal of Neuro-Ophthalmology, June 2000, Volume 20, Issue 2
Date 2000-06
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s60p452w
Setname ehsl_novel_jno
ID 225039
Reference URL https://collections.lib.utah.edu/ark:/87278/s60p452w

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Title Bilateral Ptosis with Pupil Sparing Because of a Discrete Midbrain Lesion
Creator Saeki, N; Yamaura, A; Sunami, K
Affiliation Department of Neurological Surgery, Chiba University, School of Medicine, Japan.
Abstract The topographic arrangement within the midbrain oculomotor nerve is not adequately elucidated in humans. Two patients with a partial oculomotor palsy because of a localized infarction or hematoma were treated. Both patients had bilateral ptosis, impaired adduction, and supraduction. One patient had impaired infraduction and pupillary involvement on one side. Results of computed tomography and magnetic resonance imaging revealed discrete lesions at the dorsal midbrain tegmentum that spared the rostral midbrain. The authors' cases elucidate that pupillary components take the most rostral course. This report provides indirect magnetic resonance imaging evidence to prove the course of pupillary fibers. Based on the different neuro-ophthalmologic findings in the authors' cases (sparing or affecting pupillary component and infraduction), the nerves of the inferior rectus and inferior oblique for infraduction pass more rostrally than those of medial rectus, superior rectus, and levator palpebrae. The nuclear and fascicular arrangement within the midbrain oculomotor nerve is speculated to be pupillary, extraocular, and eyelid elevation in the rostro-caudal order, based on the neuro-ophthalmologic impairment and magnetic resonance imaging findings in the authors' patients and in previous animal experiments. Knowing the fascicular and nuclear arrangement within the midbrain in detail will offer diagnostic clues for differentiation of causes for partial oculomotor palsy.
Subject Older people; Older people, 80 and over; Blepharoptosis/diagnosis; Blepharoptosis/etiology; Brain Infarction/complications; Brain Infarction/diagnosis; Female; Hematoma/complications; Hematoma/diagnosis; Humans; Intracranial Hemorrhages/complications; Intracranial Hemorrhages/diagnosis; Magnetic Resonance Imaging; Male; Mesencephalon/pathology; Middle Older people; Oculomotor Nerve/pathology; Oculomotor Nerve Diseases/diagnosis; Oculomotor Nerve Diseases/etiology; Tomography, X-Ray Computed
OCR Text Show
Format application/pdf
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
Setname ehsl_novel_jno
ID 225034
Reference URL https://collections.lib.utah.edu/ark:/87278/s60p452w/225034
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