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Journal ArticleDOI

Pathology of oculomotor nerve palsy in diabetics.

01 Aug 1970-Neurology (Neurology)-Vol. 20, Iss: 8, pp 835-835
TL;DR: The pathological findings of pupil-sparing oculomotor palsy in a diabetic patient was the first in whom the pathological neural process involved the subarachnoid segment of the third nerve.
Abstract: SUMMARYThe pathological findings of pupil-sparing oculomotor palsy in a diabetic patient are presented and discussed in view of the 2 other published necropsy studies of this disorder. Intraneural arteriolar abnormalities were seen in all 3, but our patient was the first in whom the pathological neural process involved the subarachnoid segment of the third nerve.
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Journal ArticleDOI
TL;DR: Pupillary sparing appears to be more common than previously appreciated in patients with ICA‐PoCA aneurysms and oculomotor nerve involvement and should be observed closely for at least one week for the development of pupillary involvement.
Abstract: The charts of 84 patients admitted to the Neurosurgery Service of the Washington University Medical Center between January, 1960, and July, 1981, with aneurysms at or near the junction of the internal carotid and posterior communicating arteries (ICA-PoCA) were reviewed Special emphasis was placed on the pupillary size and reactivity of 51 patients with oculomotor nerve involvement Seven initially had normal pupils, representing 8% of the total group and 14% of those presenting with oculomotor palsies In 4 of these patients pupillary involvement developed within 5 days, and in I pupillary involvement developed in 4 months Pupillary sparing appears to be more common than previously appreciated in patients with ICA-PoCA aneurysms and oculomotor nerve involvement Patients with acute somatic oculomotor paresis should be observed closely for at least one week for the development of pupillary involvement Arteriography may be indicated more frequently than previously recommended

151 citations

Book ChapterDOI
01 Dec 2005

139 citations

Journal ArticleDOI
TL;DR: While the etiology of THS is unknown, current pathogenetic theories are reviewed and careful initial patient examination and scrupulous follow-up evaluation are essential, asTHS is categorically a diagnosis of exclusion.

139 citations

Journal ArticleDOI
TL;DR: The visual outcome varied, but improvement occasionally occurred following treatment with corticosteroids, and the probable pathogenesis in all cases is vaso-occlusive disease in small vessels of the optic nerves.
Abstract: • We report data from seven cases of optic neuropathy in systemic lupus erythematosus. The visual outcome varied, but improvement occasionally occurred following treatment with corticosteroids. The clinical picture was variable and could present as acute retrobulbar optic neuritis, ischemic optic neuropathy, or slowly progressive visual loss. Visual evoked response testing revealed increased latency in two patients and loss of amplitude in two others; a fifth patient had both findings in the involved eye. Despite the variable presentation, the probable pathogenesis in all cases is vaso-occlusive disease in small vessels of the optic nerves.

138 citations

Journal ArticleDOI
TL;DR: The most favorable prognosis was with inflammatory and vascular lesions; in the latter the outcome was improved by the administration of non-steroidal anti-inflammatory drugs.

117 citations

References
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Journal ArticleDOI
TL;DR: A series of 130 consecutive patients with isolated oculomotor nerve paralysis has been examined in the Neurology Clinic of the Wills Eye Hospital during the past 20 years and serves as the basis for this study.
Abstract: Paralysis of the oculomotor nerve as a clinical sign has been well known to both the neurologist and the ophthalmologist. In recent years its relationship to underlying, potentially remediable, intracranial aneurysms has been described and emphasized.1-11Also described and becoming more recognized has been the relationship between oculomotor nerve paralysis and the relatively common metabolic disorder of diabetes mellitus.12-25 A series of 130 consecutive patients with isolated oculomotor nerve paralysis has been examined in the Neurology Clinic of the Wills Eye Hospital during the past 20 years and serves as the basis for this study. Such a series of patients would be comparable to patients who might present themselves first to an ophthalmologist. Excluded from our series have been all patients initially showing any signs referable to the nervous system other than an isolated oculomotor nerve paralysis. Present Study This survey consists of 130 patients with oculomotor nerve paralysis

174 citations