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Eye (London, England) Feb 2015We review ocular motor cranial nerve palsies in childhood and highlight many of the features that differentiate these from their occurrence in adulthood. The clinical... (Review)
Review
We review ocular motor cranial nerve palsies in childhood and highlight many of the features that differentiate these from their occurrence in adulthood. The clinical characteristics of cranial nerve palsies in childhood are affected by the child's impressive ability to repair and regenerate after injury. Thus, aberrant regeneration is very common after congenital III palsy; Duane syndrome, the result of early repair after congenital VI palsy, is invariably associated with retraction of the globe in adduction related to the innervation of the lateral rectus by the III nerve causing co-contraction in adduction. Clinical features that may be of concern in adulthood may not be relevant in childhood; whereas the presence of mydriasis in III palsy suggests a compressive aetiology in adults, this is not the case in children. However, the frequency of associated CNS abnormalities in III palsy and the risk of tumour in VI palsy can be indications for early neuroimaging depending on presenting features elicited through a careful history and clinical examination. The latter should include the neighbouring cranial nerves. We discuss the impact of our evolving knowledge of congenital cranial dysinnervation syndromes on this field.
Topics: Abducens Nerve; Abducens Nerve Diseases; Child; Child, Preschool; Eye Diseases; Humans; Nerve Regeneration; Oculomotor Nerve; Oculomotor Nerve Diseases; Trochlear Nerve; Trochlear Nerve Diseases
PubMed: 25572578
DOI: 10.1038/eye.2014.292 -
World Neurosurgery Apr 2023The oculomotor cistern (OMC) is a cerebrospinal fluid space bound by meningeal layers that surrounds the oculomotor nerve as it crosses the oculomotor triangle to reach... (Review)
Review
BACKGROUND
The oculomotor cistern (OMC) is a cerebrospinal fluid space bound by meningeal layers that surrounds the oculomotor nerve as it crosses the oculomotor triangle to reach the lateral wall of the cavernous sinus at the level of the anterior clinoid process. Although several anatomical and radiological studies are available, its anatomy and relationship with pituitary adenomas (PAs) are still matter of discussion.
OBJECTIVE
The aim of the study is to provide an updated and focused overview of the OMC, highlighting the different perspectives and descriptions from anatomical, radiological, and clinical points of view.
METHODS
A scoping review was conducted up to 29 October 2022, according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) criteria. PubMed, Web of Science, Scopus databases, and correlated citations were investigated.
RESULTS
Of the 562 records identified, 22 were included in the present analysis. There were 13, 5, and 4 anatomo-surgical, radiological, and clinical studies, respectively. Though there is general consensus on its definition, data are variable on different features of OMC. Defects or absence of dural layers adjacent to the oculomotor nerve were described in only 4 papers. The transition from meningeal to neural layers is still unclear. PAs with OMC involvement are poorly studied and have unique clinical characteristics. To date, 21 patients have been described; the reported prevalence of OMC involvement by PAs ranges from 4.1% to 14.6%.
CONCLUSIONS
Clarifying the OMC features with further systematic studies may not only broaden theoretical knowledge but also have implications on endoscopic transnasal pituitary surgery.
Topics: Humans; Adenoma; Endoscopy; Oculomotor Nerve; Pituitary Gland; Pituitary Neoplasms
PubMed: 36657712
DOI: 10.1016/j.wneu.2023.01.048 -
Surgical and Radiologic Anatomy : SRA Nov 2022No study has documented the oculomotor nerve (OMN) segment lying between the posterior cerebral (PCA) and superior cerebellar (SCA) arteries adjacent to the brainstem....
PURPOSE
No study has documented the oculomotor nerve (OMN) segment lying between the posterior cerebral (PCA) and superior cerebellar (SCA) arteries adjacent to the brainstem. The present study aimed to characterize it.
METHODS
A total of 71 patients underwent thin-sliced, sagittal T2-weighted magnetic resonance imaging for analysis.
RESULTS
The OMN segments lying between the PCA and SCA were identified in all patients. The OMN segment in relation to the PCA and SCA was classified into five types. Of them, the PCA-OMN contact type was the most frequent and found in 35.2% of 71 sides on the right and 39.4% on the left. Also, the PCA-OMN compression type was identified in 12.7% on the right and 15.5% on the left. In these types, the mean distance between the brainstem and contact/compression sites were measured 4.4 ± 2.3 mm on the right and 4.4 ± 1.6 mm on the left. In more than forty percent, the sites were located at the level of the pontomesencephalic junction.
CONCLUSIONS
The OMN may be frequently in contact with the PCA near the brainstem. The site located more distal than the central-peripheral myelin junction of the OMN can attribute to a low frequency of neurovascular compression syndrome of the nerve.
Topics: Humans; Oculomotor Nerve; Basilar Artery; Magnetic Resonance Imaging
PubMed: 36241748
DOI: 10.1007/s00276-022-03033-3 -
Human Brain Mapping May 2022The oculomotor nerve (OCN) is the main motor nerve innervating eye muscles and can be involved in multiple flammatory, compressive, or pathologies. The diffusion...
The oculomotor nerve (OCN) is the main motor nerve innervating eye muscles and can be involved in multiple flammatory, compressive, or pathologies. The diffusion magnetic resonance imaging (dMRI) tractography is now widely used to describe the trajectory of the OCN. However, the complex cranial structure leads to difficulties in fiber orientation distribution (FOD) modeling, fiber tracking, and region of interest (ROI) selection. Currently, the identification of OCN relies on expert manual operation, resulting in challenges, such as the carries high clinical, time-consuming, and labor costs. Thus, we propose a method that can automatically identify OCN from dMRI tractography. First, we choose the multi-shell multi-tissue constraint spherical deconvolution (MSMT-CSD) FOD estimation model and deterministic tractography to describe the 3D trajectory of the OCN. Then, we rely on the well-established computational pipeline and anatomical expertise to create a data-driven OCN tractography atlas from 40 HCP data. We identify six clusters belonging to the OCN from the atlas, including the structures of three kinds of positional relationships (pass between, pass through, and go around) with the red nuclei and two kinds of positional relationships with medial longitudinal fasciculus. Finally, we apply the proposed OCN atlas to identify the OCN automatically from 40 new HCP subjects and two patients with brainstem cavernous malformation. In terms of spatial overlap and visualization, experiment results show that the automatically and manually identified OCN fibers are consistent. Our proposed OCN atlas provides an effective tool for identifying OCN by avoiding the traditional selection strategy of ROIs.
Topics: Cluster Analysis; Diffusion Magnetic Resonance Imaging; Diffusion Tensor Imaging; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Oculomotor Nerve
PubMed: 35092135
DOI: 10.1002/hbm.25779 -
Neuro-Chirurgie Jan 2022Posterior communicating artery aneurysms (PCoAA) usually present with brain hemorrhage, but they might present with oculomotor nerve palsy (ONP) in about one out of five... (Review)
Review
OBJECTIVE
Posterior communicating artery aneurysms (PCoAA) usually present with brain hemorrhage, but they might present with oculomotor nerve palsy (ONP) in about one out of five patients. Treatment options include endovascular coiling and surgical clipping. The present analysis aims to compare the two treatment options for ONP due to PCoAA in terms of complete recovery and related parameters.
METHODS
A comprehensive literature search was performed for studies published between 2000 and 2019 on ONP due to PCoAA. The included studies were divided into two categories-surgical clipping (group A) and endovascular coiling (group B). The collected data were statistically processed with SPSS version 25.
RESULTS
There was a significant difference between the two treatment groups regarding complete recovery of ONP (P<0.001), suggesting superiority of the surgical clipping. The correlation analysis showed no correlations for group A. Group B had negative and positive correlations, showing that endovascular coiling results in higher rates of complete ONP recovery for elderly patients.
CONCLUSION
Surgical clipping is superior to endovascular coiling in terms of complete recovery among patients with ONP due to PCoAAs. Endovascular coiling seems to benefit older patients. While no recommendations exist for the treatment of ONP due to intracranial aneurysms, an increasing number of studies imply the superiority of operative clipping.
Topics: Aged; Aneurysm, Ruptured; Embolization, Therapeutic; Endovascular Procedures; Humans; Intracranial Aneurysm; Intracranial Hemorrhages; Neurosurgical Procedures; Oculomotor Nerve Diseases; Retrospective Studies; Treatment Outcome
PubMed: 33845117
DOI: 10.1016/j.neuchi.2021.03.012 -
Journal of Clinical Neurophysiology :... Jan 2018The utility of extraocular cranial nerve electrophysiologic recordings lies primarily in the operating room during skull base surgeries. Surgical manipulation during... (Review)
Review
The utility of extraocular cranial nerve electrophysiologic recordings lies primarily in the operating room during skull base surgeries. Surgical manipulation during skull base surgeries poses a risk of injury to multiple cranial nerves, including those innervating extraocular muscles. Because tumors distort normal anatomic relationships, it becomes particularly challenging to identify cranial nerve structures. Studies have reported the benefits of using intraoperative spontaneous electromyographic recordings and compound muscle action potentials evoked by electrical stimulation in preventing postoperative neurologic deficits. Apart from surgical applications, electromyography of extraocular muscles has also been used to guide botulinum toxin injections in patients with strabismus and as an adjuvant diagnostic test in myasthenia gravis. In this article, we briefly review the rationale, current available techniques to monitor extraocular cranial nerves, technical difficulties, clinical and surgical applications, as well as future directions for research.
Topics: Abducens Nerve; Electromyography; Humans; Neurosurgical Procedures; Oculomotor Muscles; Oculomotor Nerve; Trochlear Nerve
PubMed: 29298208
DOI: 10.1097/WNP.0000000000000417 -
The Journal of Pediatrics Nov 2015
Topics: Blepharoptosis; Child, Preschool; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Oculomotor Nerve; Oculomotor Nerve Diseases; Ophthalmoplegia
PubMed: 26282241
DOI: 10.1016/j.jpeds.2015.07.022 -
Journal of Neurophysiology Jul 2017Infantile strabismus is characterized by numerous visual and oculomotor abnormalities. Recently nonhuman primate models of infantile strabismus have been established,... (Review)
Review
Infantile strabismus is characterized by numerous visual and oculomotor abnormalities. Recently nonhuman primate models of infantile strabismus have been established, with characteristics that closely match those observed in human patients. This has made it possible to study the neural basis for visual and oculomotor symptoms in infantile strabismus. In this review, we consider the available evidence for neural abnormalities in structures related to oculomotor pathways ranging from visual cortex to oculomotor nuclei. These studies provide compelling evidence that a disturbance of binocular vision during a sensitive period early in life, whatever the cause, results in a cascade of abnormalities through numerous brain areas involved in visual functions and eye movements.
Topics: Animals; Eye Movements; Humans; Infant; Oculomotor Nerve; Oculomotor Nuclear Complex; Strabismus; Visual Cortex; Visual Pathways
PubMed: 28404829
DOI: 10.1152/jn.00934.2016 -
American Journal of Otolaryngology 2021The purpose of this study was to assess the vestibular and oculomotor function in patients with vestibular migraine (VM). And we also investigate the relationship...
AIM
The purpose of this study was to assess the vestibular and oculomotor function in patients with vestibular migraine (VM). And we also investigate the relationship between testing results and effectiveness of preventive medications in VM.
MATERIAL AND METHOD
41 patients with VM were recruited in this study and examined with cervical and ocular vestibular evoked myogenic potential(cVEMP, oVEMP), video head impulse test(vHIT), caloric test and videonystagmography. All patients were treated with preventive medications. We calculated symptomatic improvement and record episodes frequency in patients with VM. Six months later, the effectiveness of preventive medications were evaluated and the relationship between vestibular testing and effectiveness of preventive medications were analyzed further.
RESULTS
In vestibular function testing, 73% of patients with VM showed abnormal results. Abnormal cVEMP, oVEMP, vHIT, and caloric test were found in 20%, 44%, 32% and 56% respectively. The abnormal rate of oVEMP was significantly higher than that of cVEMP(p < 0.05). And the proportion of abnormal caloric test was obviously higher than that of vHIT (p < 0.05). In oculomotor function testing, 42% of the patients with VM showed pathological results which was significantly lower than that of vestibular function testing(p < 0.05). After 6 months follow-up, the proportion of prophylactic medication effectiveness was significantly higher in normal vestibular function testing group compared with the abnormal group (p < 0.05).
CONCLUSION
Abnormal vestibular and oculomotor functions are commonly observed in patients with VM. And these patients with abnormal vestibular function possess a weak effectiveness of preventive medications.
Topics: Adult; Aged; Caloric Tests; Female; Follow-Up Studies; Head Impulse Test; Humans; Male; Middle Aged; Migraine Disorders; Oculomotor Nerve; Time Factors; Treatment Outcome; Vestibular Evoked Myogenic Potentials; Vestibular Function Tests; Vestibule, Labyrinth; Young Adult
PubMed: 34218215
DOI: 10.1016/j.amjoto.2021.103152 -
Journal of AAPOS : the Official... Feb 2023Addressing ocular misalignment secondary to partial and complete oculomotor nerve palsy presents a special challenge to the strabismus surgeon, particularly when... (Review)
Review
Addressing ocular misalignment secondary to partial and complete oculomotor nerve palsy presents a special challenge to the strabismus surgeon, particularly when treating patients with binocular diplopia. We review the reported surgical options and, through illustrative cases, provide our own perspective on managing this disorder.
Topics: Humans; Oculomotor Muscles; Retrospective Studies; Oculomotor Nerve Diseases; Strabismus; Diplopia; Vision, Binocular
PubMed: 36640897
DOI: 10.1016/j.jaapos.2022.11.017