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The Journal of the Royal College of... Dec 2021
Topics: Humans; Magnetic Resonance Imaging; Oculomotor Nerve Diseases
PubMed: 34882150
DOI: 10.4997/JRCPE.2021.425 -
Tidsskrift For Den Norske Laegeforening... Oct 2017
Topics: Aged, 80 and over; Aneurysm, Ruptured; Computed Tomography Angiography; Female; Humans; Intracranial Aneurysm; Oculomotor Nerve Diseases; Subarachnoid Hemorrhage
PubMed: 29043749
DOI: 10.4045/tidsskr.17.0431 -
Surgical Neurology International 2019Oculomotor nerve schwannoma (ONS) is an extremely rare intracranial benign tumor. Till date, there is no standard treatment of oculomotor schwannoma. Here, we present an... (Review)
Review
BACKGROUND
Oculomotor nerve schwannoma (ONS) is an extremely rare intracranial benign tumor. Till date, there is no standard treatment of oculomotor schwannoma. Here, we present an illustrative case report of ONS, perform a systematic review of literature on surgically and radiosurgically treated cases and morbidity related to both treatment modalities.
METHODS
We performed a systematic review of literature for cases with ONS treated with surgery or radiosurgery using PubMed/Ovid Medline.
RESULTS
Till date, there are 60 reported cases of ONS (45 treated surgically and seven radiosurgically) with the dominance of female gender (53%) and mean age of 35.2 years (Range 1-66). In 8% of the cases, there was no involvement of cranial nerve (CN) III and 92% of the cases CN III alone or together with CN II, IV, V, and VI. In 67% of the cases a complete resection and 33% a partial resection performed. In 73% of the cases, postoperative third nerve palsy was documented, 22% improved after surgery and in around 5% of cases, the outcome was not described. In the radiosurgically treated cases of nonvestibular schwannoma including ONS, the progression-free interval of approximately 2 years was above 90%.
CONCLUSION
Due to the high rate of postoperative complete oculomotor nerve palsy, a subtotal resection avoiding the nerve injury seems to be a feasible option. Radiosurgery is another option to treat small size schwannoma. A combined treatment with microsurgery followed by radiosurgery may allow effective treatment for large size oculomotor schwannoma.
PubMed: 31528378
DOI: 10.25259/SNI-75-2019 -
Neuroimaging Clinics of North America Aug 2015Eye movement is controlled by ocular motor pathways that encompass supranuclear, nuclear, and infranuclear levels. Lesions affecting certain locations may produce... (Review)
Review
Eye movement is controlled by ocular motor pathways that encompass supranuclear, nuclear, and infranuclear levels. Lesions affecting certain locations may produce localizing signs that help radiologists focus on specific anatomic regions. Some pathologic conditions, such as aneurysms and meningiomas, have unique imaging characteristics that may preclude unnecessary tissue biopsies. Some conditions are life threatening and require urgent or emergent imaging. MR imaging is the imaging of choice in evaluation of ocular motor palsy, with magnetic resonance angiography or computed tomography angiography indicated in cases of suspected aneurysms or neurovascular conflicts.
Topics: Angiography; Cranial Nerve Neoplasms; Humans; Nerve Compression Syndromes; Neuroimaging; Oculomotor Nerve; Oculomotor Nerve Diseases; Oculomotor Nerve Injuries
PubMed: 26208418
DOI: 10.1016/j.nic.2015.05.006 -
Journal Francais D'ophtalmologie Jan 2018Oculomotor palsy is one of the most frequent neuro-ophthalmologic complications of diabetic patients. It generates less interest in the literature than the other ocular...
INTRODUCTION
Oculomotor palsy is one of the most frequent neuro-ophthalmologic complications of diabetic patients. It generates less interest in the literature than the other ocular manifestations. Our goal was to study the clinical, epidemiological, therapeutic and prognostic characteristics of oculomotor palsy in the diabetic.
METHODS
This is a retrospective study of 24 diabetic patients with oculomotor palsy. The ophthalmological examination emphasized ocular motility. We performed an orthoptic assessment and a Hess-Lancaster test. Neuro-imaging was ordered in case of IIIrd and IVth nerve involvement, bilateral involvement, multiple ocular cranial nerve palsy or associated optic neuropathy. Treatment consisted of glucose management and alternating monocular occlusion or prisms for the diplopia. Data were entered and analyzed on SPSS 11.5 software.
RESULTS
The mean age of the patients was 58.5±11.9 years. Binocular diplopia was the main symptom. The oculomotor palsy involved the VIth nerve in 50% of cases and was bilateral in two cases. Three patients also had an optic neuropathy. The mean duration of diabetes was 11.7±11 years; poorly controlled diabetes was found in 75% of cases and an association with diabetic retinopathy was noted in 56% of cases.
CONCLUSIONS
Long-standing uncontrolled type 2 diabetes, hypertension, coronary artery disease, left ventricular hypertrophy, and elevated hematocrit are the most common risk factors. The VIth nerve is commonly involved. Certain characteristics of the pupillary light reflex can help to differentiate an ischemic insult from an aneurysmal injury to the IIIrd nerve.
Topics: Abducens Nerve Diseases; Adult; Aged; Aged, 80 and over; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Diabetic Retinopathy; Disease Progression; Female; Humans; Male; Middle Aged; Oculomotor Nerve Diseases; Ophthalmoplegia; Retrospective Studies
PubMed: 29290461
DOI: 10.1016/j.jfo.2017.06.010 -
Developmental Biology Aug 2021Muscle function is dependent on innervation by the correct motor nerves. Motor nerves are composed of motor axons which extend through peripheral tissues as a compact...
Muscle function is dependent on innervation by the correct motor nerves. Motor nerves are composed of motor axons which extend through peripheral tissues as a compact bundle, then diverge to create terminal nerve branches to specific muscle targets. As motor nerves approach their targets, they undergo a transition where the fasciculated nerve halts further growth then after a pause, the nerve later initiates branching to muscles. This transition point is potentially an intermediate target or guidepost to present specific cellular and molecular signals for navigation. Here we describe the navigation of the oculomotor nerve and its association with developing muscles in mouse embryos. We found that the oculomotor nerve initially grew to the eye three days prior to the appearance of any extraocular muscles. The oculomotor axons spread to form a plexus within a mass of cells, which included precursors of extraocular muscles and other orbital tissues and expressed the transcription factor Pitx2. The nerve growth paused in the plexus for more than two days, persisting during primary extraocular myogenesis, with a subsequent phase in which the nerve branched out to specific muscles. To test the functional significance of the nerve contact with Pitx2+ cells in the plexus, we used two strategies to genetically ablate Pitx2+ cells or muscle precursors early in nerve development. The first strategy used Myf5-Cre-mediated expression of diphtheria toxin A to ablate muscle precursors, leading to loss of extraocular muscles. The oculomotor axons navigated to the eye to form the main nerve, but subsequently largely failed to initiate terminal branches. The second strategy studied Pitx2 homozygous mutants, which have early apoptosis of Pitx2-expressing precursor cells, including precursors for extraocular muscles and other orbital tissues. Oculomotor nerve fibers also grew to the eye, but failed to stop to form the plexus, instead grew long ectopic projections. These results show that neither Pitx2 function nor Myf5-expressing cells are required for oculomotor nerve navigation to the eye. However, Pitx2 function is required for oculomotor axons to pause growth in the plexus, while Myf5-expressing cells are required for terminal branch initiation.
Topics: Animals; Axons; Female; Gene Expression; Gene Expression Regulation; Homeodomain Proteins; Mice; Muscle Development; Myogenic Regulatory Factor 5; Oculomotor Muscles; Oculomotor Nerve; Pregnancy; Transcription Factors; Homeobox Protein PITX2
PubMed: 33905720
DOI: 10.1016/j.ydbio.2021.04.006 -
World Neurosurgery Nov 2022To evaluate the relationship between the oculomotor nerve (CNIII) and the internal carotid artery (ICA) as a new anatomic-radiologic landmark for distinguishing the...
The Intersection Between the Oculomotor Nerve and the Internal Carotid Artery to Distinguish Extracavernous and Intracavernous Paraclinoid Aneurysms Using Anatomic Dissections-A New 3T Magnetic Resonance Imaging Protocol Confirmed by Three-Dimensionally Printed Biomodels.
OBJECTIVE
To evaluate the relationship between the oculomotor nerve (CNIII) and the internal carotid artery (ICA) as a new anatomic-radiologic landmark for distinguishing the exact location of a paraclinoid intracranial aneurysm (IA).
METHODS
Microanatomic dissections were performed in 20 cavernous sinuses to evaluate the ICA paraclinoid region. Based on anatomic observations, a new magnetic resonance (MRI) protocol to classify paraclinoid aneurysms was proposed. MRI of 42 IAs from 34 patients was independently analyzed and classified as intracavernous, extracavernous, or transitional by 2 neuroradiologists. To validate the proposed MRI protocol, each IA was classified by a three-dimensionally (3D) printed biomodel and agreement with the radiologic classifications was evaluated. Of 42 IAs, 23 undergoing microsurgeries were also classified by direct visualization.
RESULTS
We observed that the true cavernous sinus roof is defined by the carotid-oculomotor membrane, which has an intimate relationship with the intersection between the superior limit of the CNIII and the ICA. Based on this intersection, all 42 IAs were radiologically classified and agreement with the 3D printed biomodels was observed in 95% IAs. Concordance tests showed a statistically significant (P < 0.05) agreement between the classifications. All 23 IAs treated had the radiologic and 3D biomodel classification confirmed.
CONCLUSIONS
The intersection between the ICA and the CNIII, which crosses it transversely in its entire diameter, is a reliable anatomic-radiologic landmark to correctly classify paraclinoid aneurysms. Through a new MRI protocol, it is possible to radiologically identify this intersection and to easily distinguish the intracavernous and extracavernous ICA paraclinoid aneurysms.
Topics: Humans; Carotid Artery, Internal; Oculomotor Nerve; Intracranial Aneurysm; Magnetic Resonance Imaging; Carotid Artery Diseases; Printing, Three-Dimensional
PubMed: 35970294
DOI: 10.1016/j.wneu.2022.08.030 -
American Journal of Physical Medicine &... May 2020Isolated oculomotor nerve palsy is rarely encountered after mild traumatic brain injury. It is difficult to offer patients accurate management strategies or prognostic... (Review)
Review
BACKGROUND
Isolated oculomotor nerve palsy is rarely encountered after mild traumatic brain injury. It is difficult to offer patients accurate management strategies or prognostic assessments because only a few reports have described the management of oculomotor nerve palsy.
METHODS
We performed a search for all clinical studies of isolated oculomotor nerve palsy after mild traumatic brain injury published up to July 9, 2019. We placed no restrictions on language or year of publication in our search, and we searched the following key words: traumatic brain injury, isolated oculomotor nerve palsy, mild head trauma, management, and prognosis.
RESULTS
We identified 14 cases of isolated oculomotor nerve palsy after mild traumatic brain injury. In three cases, steroids were used to manage the oculomotor nerve palsy. Five patients who had underlying brain lesions underwent surgery, and seven patients were observed and followed up. The time to partial or complete resolution was 6.0 ± 5.3 mos with a range of 0.5-18 mos.
CONCLUSIONS
This review includes a survey of surgical treatment for the management of traumatic brain injury that underlies oculomotor nerve palsies, steroid therapy to reduce related brain edema, and oculomotor rehabilitation with training eye movement behavior.
Topics: Brain Injuries, Traumatic; Humans; Oculomotor Nerve Diseases; Prognosis; Risk Factors
PubMed: 31609729
DOI: 10.1097/PHM.0000000000001316 -
Klinische Monatsblatter Fur... Nov 2017After just a clinical examination, the experienced neurologist can assign specific symptoms quite precisely to distinct lesions within the brain and other parts of the... (Review)
Review
After just a clinical examination, the experienced neurologist can assign specific symptoms quite precisely to distinct lesions within the brain and other parts of the nervous system, on the basis of his neuroanatomical knowledge. This also holds true for lesions affecting the oculomotor system. The aim of this article is to give a comprehensive overview of the neuroanatomical basis of the oculomotor system, in order to facilitate the precise spatial assignment of potential lesions affecting the control of eye movements. After a brief introduction, the components of the system are discussed, including the extraocular muscles and their innervating nerves. The following section will then cover the control of eye movements and will specifically address distinct patterns of eye movements and areas within the central nervous system controlling these. This article also gives a brief overview of the intraocular muscles and their control.
Topics: Accommodation, Ocular; Brain Mapping; Convergence, Ocular; Eye Movements; Geniculate Bodies; Mesencephalon; Neural Pathways; Neurons; Oculomotor Muscles; Oculomotor Nerve; Optic Tract; Pursuit, Smooth; Reflex, Pupillary; Saccades; Spinal Cord; Visual Pathways
PubMed: 28898914
DOI: 10.1055/s-0043-117741 -
Somatosensory & Motor Research 2018Oculomotor nerve palsy (ONP) is an important and common clinical diagnosis. Its main features are diplopia and ptosis. Its aetiologies are various and complex. A number... (Review)
Review
Oculomotor nerve palsy (ONP) is an important and common clinical diagnosis. Its main features are diplopia and ptosis. Its aetiologies are various and complex. A number of different conditions have been reported to cause ONP, such as diabetes mellitus, aneurysm, tumours, painful ophthalmoplegia, pituitary lesions, cavernous sinus lesions, central nervous system infections, and subarachnoid haemorrhage. A patients needs to undergo several tests in order to establish the correct underlying pathology. In this review, we have summarized the aetiologies of the unilateral ONP, and discussed their relative clinical features, pathogenesis, diagnostic criteria, treatment options, and prognosis. We searched PubMed for papers related to ONP and its aetiologies, and selected the publications, which seemed appropriate.
Topics: Animals; Functional Laterality; Humans; Oculomotor Nerve Diseases; PubMed
PubMed: 30592440
DOI: 10.1080/08990220.2018.1547697