• Title/Summary/Keyword: Oculomotor Nerve

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Triggered Electrooculography for Identification of Oculomotor and Abducens Nerves during Skull Base Surgery

  • Jeong, Ha-Neul;Ahn, Sang-Il;Na, Minkyun;Yoo, Jihwan;Kim, Woohyun;Jung, In-Ho;Kang, Soobin;Kim, Seung Min;Shin, Ha Young;Chang, Jong Hee;Kim, Eui Hyun
    • Journal of Korean Neurosurgical Society
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    • v.64 no.2
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    • pp.282-288
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    • 2021
  • Objective : Electrooculography (EOG) records eyeball movements as changes in the potential difference between the negatively charged retina and the positively charged cornea. We aimed to investigate whether reliable EOG waveforms can be evoked by electrical stimulation of the oculomotor and abducens nerves during skull base surgery. Methods : We retrospectively reviewed the records of 18 patients who had undergone a skull base tumor surgery using EOG (11 craniotomies and seven endonasal endoscopic surgeries). Stimulation was performed at 5 Hz with a stimulus duration of 200 μs and an intensity of 0.1-5 mA using a concentric bipolar probe. Recording electrodes were placed on the upper (active) and lower (reference) eyelids, and on the outer corners of both eyes; the active electrode was placed on the contralateral side. Results : Reproducibly triggered EOG waveforms were observed in all cases. Electrical stimulation of cranial nerves (CNs) III and VI elicited positive waveforms and negative waveforms, respectively, in the horizontal recording. The median latencies were 3.1 and 0.5 ms for craniotomies and endonasal endoscopic surgeries, respectively (p=0.007). Additionally, the median amplitudes were 33.7 and 46.4 μV for craniotomies and endonasal endoscopic surgeries, respectively (p=0.40). Conclusion : This study showed reliably triggered EOG waveforms with stimulation of CNs III and VI during skull base surgery. The latency was different according to the point of stimulation and thus predictable. As EOG is noninvasive and relatively easy to perform, it can be used to identify the ocular motor nerves during surgeries as an alternative of electromyography.

Intentional Sparing of Daughter Sac from Coil Packing in the Embolization of Aneurysms Causing the Third Cranial Nerve Palsy : Initial Clinical and Radiological Results

  • Kang, Chang-Woo;Kwon, Hyon-Jo;Jeong, Se-Jin;Koh, Hyeon-Song;Choi, Seung-Won;Kim, Seon-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.115-118
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    • 2010
  • Objective : Cerebral aneurysms which cause oculomotor nerve [cranial nerve (CN) III] palsy, are frequently found with a daughter sac of the aneurysm dome. We assumed that CN III might be compressed by the daughter sac and it would be more helpful not to fill the daughter sac with coils than vice versa during endosaccular embolization for recovering from CN III palsy, because it may give a greater chance for the daughter sac to shrink by itself later. We reviewed the initial results of our experiences of such cases. Methods : Among 9 aneurysms accompanied by CN III palsy, 7 (6 unruptured, 1 ruptured) showed a daughter sac. We tried to fill the main dome completely and spare the daughter sac from coil filling to increase the possibility of decompression. We evaluated the short-term effectiveness of this concept using medical records and angiograms. Results : After initial embolization, all of CN III palsy caused by unruptured aneurysms (6/6) resolved completely after various periods (3-90 days) of time. No adverse effects were noted during and after the procedures except for one case of harmless coil stretching during coil filling using double microcatheter. Conclusion : During the coil embolization of the cerebral aneurysm causing CN III palsy, sparing the daughter sac from coil packing while tightly packing the main dome, can be helpful in increasing the effectiveness of decompression. However, a long-term follow-up will be required.

Case of Monocular Partial Oculomotor Nerve Palsy in a Patient with Midbrain and Thalamus Hemorrhage (중뇌 및 시상 출혈 환자에 나타난 단안의 부분 동안신경마비 증례보고)

  • Rhee, Jae-Hwa;Kim, Young-Eun;Kim, Il-Wha;Lee, Key-Sang;Lee, Seung-Geun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.2
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    • pp.333-337
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    • 2010
  • A 51-year-old man developed diplopia while driving. The brain CT film demonstrated a hemorrhage in the left midbrain and thalamus. On our first diagnosis after 8 days from onset, partial ptosis and limitation of adduction in the left eye were detected. We evaluated that the patinet's digestive system was weak, so that treated the patient with Bojungikki-tang and Sa-am acupuncture Bi-Jung-Geouk(脾正格). As a result, limitation of adduction was recovered to about 90% of normal range and Ptosis was recovered just likely with the normal eye.

Cerebral Vasospasm with Delayed Ischemic Neurologic Deficit after Unruptured Aneurysm Surgery : Report of Two Cases and Review of the Literature

  • Kim, Myungsoo;Son, Wonsoo;Kang, Dong-Hun;Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.665-670
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    • 2021
  • Symptomatic cerebral vasospasm (CVS) and delayed ischemic neurologic deficit (DIND) after unruptured aneurysm surgery are extremely rare. Its onset timing is variable, and its mechanisms are unclear. We report two cases of CVS with DIND after unruptured aneurysm surgery and review the literature regarding potential mechanisms. The first case is a 51-year-old woman with non-hemorrhagic vasospasm after unruptured left anterior communicating artery aneurysm surgery. She presented with delayed vasospasm on postoperative day 14. The second case is a 45-year-old woman who suffered from oculomotor nerve palsy caused by an unruptured posterior communicatig artery (PCoA) aneurysm. DIND with non-hemorrhagic vasospasm developed on postoperative day 12. To our knowledge, this is the first report of symptomatic CVS with oculomotor nerve palsy following unruptured PCoA aneurysm surgery. CVS with DIND after unruptured aneurysm surgery is very rare and can be triggered by multiple mechanisms, such as hemorrhage, mechanical stress to the arterial wall, or the trigemino-cerebrovascular system. For unruptured aneurysm surgery, although it is rare, careful observation and treatments can be needed for postoperative CVS with DIND.

The Analysis on Trend of Articles about Strabismus in Journal of Korean Medicine (국내 한의학 학술지에 게재된 사시 관련 논문들의 경향성 분석)

  • Kim, Young-Bin;Kwon, Kang
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.1
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    • pp.13-28
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    • 2021
  • Objectives : Strabismus is a disease that can be observed and treated directly from the outside. Therefore, it is very important in Korean medicine ophthalmology in accessibility to treatment. This study is designed to investigate the trends of strabismus-related studies published in Journal of Korean medicine. Methods : 5 Internet databases were selected to search for the study subject. The following 9 keywords were used; Strabismus, Heterophoria, Binocular vision, Visual acuity, Diplopia, Paralytic, Cover test, Oculomotor nerve paralysis, Abducens nerve paralysis. Through this process, a total of 45 studies were found and analyzed into 5 categories ; publication year, publication journal, number of author, type of article, analyzation of case report. Results : There were 2 review articles, 1 original article and 42 case reports. 5 studies(11.1%) were published in 2004 year. Journal of Korean Oriental Medical Ophthalmology & Otolaryngology & Dermatology were the most common with 40%. The authors were often 2 and 3 (each 22.2%). In the case report study, the treatment period was most often 1-30 days (35.7%). Conclusions : 42 studies were on paralytic strabismus and 1 study was on paralytic and non-paralytic strabismus. These results represent that the studies are concentrated in case reports about paralytic strabismus, but this seems to be an area to be improved in future research.

A Case Report of Ptosis Patient Diagnosed as Idiopathic Oculomotor Nerve Palsy (특발성(特發性) 동안신경마비(動眼神經麻痺)로 진단된 안검하수(眼瞼下垂) 환자 치험 1례)

  • Kim, Tae-Yeon;Kim, Hyun-Jung;Lee, Chang-Won;Kim, Chang-Hwan
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.26 no.3
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    • pp.77-86
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    • 2013
  • Objective : This study reports the effect of korean medicine on ptosis patient 1 case diagnosed as idiopathic oculomoter nerve palsy. Methods : We experienced one case of ptosis diagnosed as idiopathic oculomoter nerve palsy treated with herbal medicine and acupuncture. Ptosis and associated symptoms had been estimated with difference of both eye's interpalpebral fissure and VAS(Visual Analogue Scale). Result : After the treatment, symptoms were decreased and almost disappeared. In this case, difference of both eye's interpalpebral fissure decreased from 6mm to 1mm in a month. Conclusion : This study suggests that korean medicine is effective on ptosis diagnosed as idiopathic oculomoter nerve palsy.

One Clinical Study on Strabismus Patient of Abducence Nerve Paralysis with Oriental Medicine (제6 뇌신경 마비로 진단된 마비성(痲痺性) 사시(斜視) 환아(患兒) 1례(例) 보고(報告))

  • Cheon, Jin-Hong;Min, Sang-Yeon;Kim, Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.24 no.3
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    • pp.26-32
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    • 2010
  • Objectives: This study is to report a case of the paralytic strabismus with herbal medicine and acupuncture. Strabismus refers to the oculomotor muscles imbalance resulted from improper alignment of the visual axis of the two eyes. Our goal is to know the effectiveness and safety in children from oriental medicine. Methods: We treated the case by using herbal medicine, acupuncture, and etc. Results: We found that the case was recovered perfectly in short term(24days) without any side effects or complaints. Therefore, we try to apply this treatment in many children cases and to set as a guideline protocol to treat for children. Conclusions: The case showed proper oriental medical treatment is better choice for therapy than surgery or observation.

A Case Study of Ocular Motility Disorders caused by Thalamus, Midbrain and Pontine Infarctions (시상, 중간뇌, 다리뇌 경색에 의한 안구운동장애 치험 1례)

  • Eom, Ye-Jin;Hong, Chul-Hee
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.28 no.4
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    • pp.130-141
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    • 2015
  • Objectives : The aim of this study is to report the effect of Korean medicine treatment on ocular motility disorders (ptosis, bilateral upward gaze palsy, adduction impairment, and strabismus) caused by thalamus, midbrain and pontine infarctions.Methods : The patient was treated by using acupuncture, hominis placenta pharmacoacupuncture, and electroacupuncture treatment. The change of ptosis was evaluated by measurement of palpebral fissure width. The change of gaze palsy and strabismus were evaluated by comparison the photographs of the extraocular movements of patient. Strabismus also was evaluated by corneal reflex test.Results : Gaze palsy and strabismus were improved. Ptosis disappeared after Korean medicine treatment.Conclusions : Korean medicine treatment should be effective for the ocular motility disorders caused by thalamus, midbrain and pontine infarctions.

Oriental-western Cooperative Treatment Clinical Sudy of Side Effect after Filler Injection Glabella Region (필러시술이후 발생한 부작용의 한.양방 병행치료 1례)

  • Kim, Bong-Hyun;Nam, Hae-Jeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.24 no.2
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    • pp.79-86
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    • 2011
  • Objective : The purpose of this study is to report the oriental-western cooperative treatment on opthalmic and dermatologic disease caused by adverse effect of filler injection galbella region. Method : After filler injection, a patient suffers from spontenous blineness and palsy of oculomotor and trochlear nerve on right eye and erythema on glabella and nasal region. She is admitted to kyung-hee oriental hospital for 2 weeks with oriental(herbal-medicine, acupunture and nega treatment) and western(department of opthalmology, dermatology and plastic surgery measurement) treatment. Result & Conclusion : Nerve palsy was recovered near to normal. And skin legion was proceeded to recovery period without any complication. This recovery speed with oriental-western cooperative treatment is much faster than usual treatment.