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Show LITERATURE ABSTRACTS 51 Neuroophthalmology Unit, The Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel.] These authors describe two patients with a sixth nerve palsy associated with an ipsilateral Horner's syndrome. They predict that such a situation may arise with compression of sympathetic fibers as they pass from the carotid canal through the sixth nerve en route to the fifth nerve, but find that such cases rarely have been reported. Their first case had associated periorbital pain and subsequently developed complete ophthalmoplegia before a large, infraclinoid carotid aneurysm was diagnosed. The second patient had known breast carcinoma and a paracavernous lesion presumed to be a metastasis. Cocaine testing was positive in both cases, but hydroxyamphetamine testing was not done. Considering the pain in case one, concomitant fifth nerve involvement seems likely; case two, however, does seem to be a bona fide example of an isolated sixth nerve palsy and Horner's syndrome arising from cavernous sinus disease. Lyn A. Sedwick, M.D. The Use of Clonazepam in the Treatment of Nystagmus- induced Oscillopsia. Currie JN, Matsuo V. Ophthalmology 1986;93:924-32 Guly). [Reprint requests to Jon Currie, M.B., F.R.A.CP., National Eye Institute, Building 10, Room 105227, National Institutes of Health, Bethesda, MD 20892.] Ten patients with oscillopsia from downbeating, upbeating, seesaw, circular, or rotary nystagmus caused by a variety of diseases were given clonazepam, first as a test dose of 2 mg and then therapeutically. Most patients tolerated this medication, and some used clonazepam only at particularly symptomatic times of day. Also, in some patients, the trial of clonazepam was useful in determining whether decreased visual acuity was secondary to nystagmus or not, and a number of treated patients had improvement in visual acuity. Eye movement recordings are presented, but one does not need to be a "nystagmographer" to appreciate the importance of this article to patients incapacitated by their downbeating nystagmus. Commentary by Dr. Robert Yee encourages further work with this promising therapy. Lyn A. Sedwick, M.D. Intracranial Glioblastoma Invading the Orbit. Lawton AW, Karesh JW. Arch Ophthalmol 1986; 104:1116-7 (Aug). A 30-year-old woman with a previously excised right frontal glioblastoma presented with right proptosis and a palpable superotemporal orbital mass. Computerized tomography showed recurrent right frontal tumor with extension into the right orbit and ethmoid sinus superiorly. Orbital biopsy confirmed glioblastoma multiforme. The authors note that all previous similar cases have occurred in patients who have had craniotomies, and they speculate that this surgical trauma may be necessary to allow orbital extension. Clearly, a patient with new proptosis who has had a previous craniotomy for glioblastoma should be investigated for the same tumor in the orbit. Lyn A. Sedwick, M.D. Abduction Deficit Secondary to Presumed Bacterial Dacryoadenitis. Ullman 5, Sergott R. Arch Ophthalmol1986;104:1127-8 (Aug). [No reprint information given.] A 20-year-old woman presented with right upper lid swelling, mucopurulent discharge, and a mild abduction deficit in the right eye. Computerized tomography showed an enlarged and enhancing right lacrimal gland. Intravenous antibiotic resulted in resolution of all signs and symptoms, and follow-up computerized tomography was normal. The authors note that ocular motility abnormalities associated with dacryoadenitis usually result from mechanical limitation of elevation and abduction from the lacrimal gland enlargement. They feel that their case is unique because of the isolated abduction deficit, which apparently resulted from contiguous inflammation from the lacrimal gland to the lateral rectus muscle. Lyn A. Sedwick, M.D. Brow Droop After Superficial Temporal Artery Biopsy. Slavin ML. Arch Ophthalmol 1986;104:1127 (Aug). [No reprint information given.] Temporal artery biopsy is almost always a complication- free procedure; however, this case report J Clill NeuYo-ophlhalmol, Vol. 7, No.1, 1987 |