• Journal of Korean Neurosurgical Society
• /
• 제47권5호
• /
• pp.392-394
• /
• 2010

Trochlear nerve palsy associated with spontaneous subarachnoid hemorrhage (SAH) is known to be a rare malady. We report here on a patient who suffered with left trochlear nerve palsy following rupture of a right posterior communicating artery aneurysm. A 56-year-woman visited our emergency department with stuporous mental change. Her Hunt-and-Hess grade was 3 and the Fisher grade was 4. Cerebral angiography revealed a ruptured aneurysm of the right posterior communicating artery. The aneurysm was clipped via a right pterional approach on the day of admission. The patient complained of diplopia when she gazed to the left side, and the ophthalmologist found limited left inferolateral side gazing due to left superior oblique muscle palsy on day 3. Elevated intracranial pressure, intraventricular hemorrhage or a dense clot in the basal cisterns might have caused this trochlear nerve palsy.

• Journal of Yeungnam Medical Science
• /
• 제36권2호
• /
• pp.159-162
• /
• 2019

The most cases with orbital metastases have been reported in patients with a prior established diagnosis of cancer and widespread systemic involvement. However, ocular symptoms can be developed as an initial presentation of cancer in patients without cancer history. We report a case of rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer.

• The Korean Journal of Pain
• /
• 제26권2호
• /
• pp.199-202
• /
• 2013

Epiduroscopic laser discectomy and neural decompression (ELND) is known as an effective treatment for intractable lumbar pain and radiating pain which develop after lumbar surgery, as well as for herniation of the intervertebral disk and spinal stenosis. However, various complications occur due to the invasiveness of this procedure and epidural adhesion, and rarely, cranial nerve damage can occur due to increased intracranial pressure. Here, the authors report case in which double vision occurred after epiduroscopic laser discectomy and neural decompression in a patient with failed back surgery syndrome (FBSS).

• Annals of Clinical Neurophysiology
• /
• 제21권2호
• /
• pp.105-107
• /
• 2019

Acute ophthalmoparesis that includes the oculomotor, trochlear, or abducens nerve may occur as an initial presentation of Miller Fisher syndrome (MFS). The symptoms of MFS or variant forms of Guillain-Barre syndrome are pathogenically related to anti-GQ1b antibodies. We report a case of a 36-year-old man with unilateral isolated abducens nerve palsy associated with anti-GM1 antibody. To the best of our knowledge, this is the first report of unilateral isolated abducens nerve palsy with positivity for anti-GM1 immunoglobulin M antibody.

• 대한안과학회지
• /
• 제59권11호
• /
• pp.1087-1090
• /
• 2018

목적: 중뇌(midbrain) 등쪽(dorsal)의 사구수조지방종(quadrigeminal cistern lipoma)에 의한 도르래신경마비를 경험하였기에 이를 보고하고자 한다. 증례요약: 65세 남자가 2년 전부터 간헐 양안 수직 복시가 있었으나 별다른 치료 없이 지내다가 2주 전부터 항상 증상이 생겨 내원하였다. 1달 전 진단받은 당뇨 이외에 다른 전신질환의 과거력은 없었다. 시력은 우안 20/25, 좌안 20/20이었고, 상대구심동공운동장애는 없었다. 안구운동검사에서 원거리 주시에서 4프리즘디옵터(prism diopters, PD)의 좌안 상사시와 근거리에서 4PD의 외사시를 보였다. 좌안은 내전시상전(elevation in adduction)이 있었다. 머리기울임검사에서 좌측 기울임에서 6PD의 좌안 상사시가 보였고, 우측 기울임에서는 정위를 보였다. 안저검사에서 우안 외회선과 좌안 내회선이 보였다. 뇌자기공명영상(brain magnetic resonance imaging)에서 중뇌 등쪽에서 나오는 도르래신경에 인접한 사구수조지방종을 확인하였다. 복시 증상의 완화를 위해 프리즘 안경을 처방하였고, 다른 신경 증상을 동반하지 않아 뇌 병변에 대한 경과관찰을 시행하기로 하였다. 결론: 중뇌 등쪽의 사구수조지방종으로 인해 도르래신경마비를 확인하였다. 종양의 압박에 의한 도르래신경마비는 드물지만, 본 증례와 같이 비특이적인 증상을 보인 도르래신경마비 환자에서는 빠른 뇌영상검사가 원인 감별에 도움을 줄 수 있다.

• 한방안이비인후피부과학회지
• /
• 제28권4호
• /
• pp.130-141
• /
• 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.

• 한방안이비인후피부과학회지
• /
• 제24권2호
• /
• pp.79-86
• /
• 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.