• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.392-394
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• 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
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• v.36 no.2
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• pp.159-162
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• 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
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• v.26 no.2
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• pp.199-202
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• 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
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• v.21 no.2
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• pp.105-107
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• 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.

• Journal of The Korean Ophthalmological Society
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• v.59 no.11
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• pp.1087-1090
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• 2018

Purpose: To report a case of trochlear nerve palsy caused by quadrigeminal cistern lipoma located in the dorsal midbrain. Case summary: A 65-year-old male visited our clinic for intermittent vertical diplopia over 2-year period. Symptoms of diplopia had worsened over the past two weeks. He had no previous medical history except having had diabetes for 1 month. The best-corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. Pupillary examination was not remarkable. Extraocular examination showed 4 prism diopters (PD) left hypertropia at distant gaze and 4 PD exotropia at near gaze, with adduction elevation of the left eye. The Bielschowsky head tilt test revealed 6 PD left hypertropia on the left gaze and orthotropia on the right tilt. Fundus examination showed excyclotorsion of the right eye and incyclotorsion of the left eye. Brain magnetic resonance imaging revealed quadrigeminal cistern lipoma. Prism glasses were prescribed to alleviate diplopia, and we followed up the lesions without further treatment. Conclusions: Trochlear nerve palsy can be caused by quadrigeminal cistern lipoma; however, it is uncommon for this condition to be caused by a compressive lesion. Prompt neuroimaging can be helpful to rule out the causes of this condition in patients with atypical symptoms.

• 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.

• 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.