ABSTRACT
BACKGROUND: Cranial nerve schwannomas are radiologically characterized by nodular cranial nerve enhancement on magnetic resonance imaging (MRI). Schwannomas typically present with gradually progressive symptoms, but isolated reports have suggested that schwannomas may cause fluctuating symptoms as well. METHODS: This is a report of ten cases of presumed cranial nerve schwannoma that presented with transient or recurring ocular motor nerve deficits. RESULTS: Schwannomas of the third, fourth, and fifth nerves resulted in fluctuating deficits of all 3 ocular motor nerves. Persistent nodular cranial nerve enhancement was present on sequential MRI studies. Several episodes of transient oculomotor (III) deficts were associated with headaches, mimicking ophthalmoplegic migraine. CONCLUSIONS: Cranial nerve schwannomas may result in relapsing and remitting cranial nerve symptoms.
Subject(s)
Cranial Nerve Neoplasms/complications , Neurilemmoma/complications , Oculomotor Nerve Diseases/diagnosis , Oculomotor Nerve Diseases/etiology , Adult , Aged , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Young AdultABSTRACT
BACKGROUND: The major precipitants of intermittent diplopia secondary to a phoria breakdown include fatigue and illness. PURPOSE: To describe cold-induced vertical diplopia in a mother and daughter. METHODS: Retrospective report. RESULTS: Mother and daughter both developed vertical diplopia after exposure to cold ambient temperatures. These symptoms remained stable over many years. Ocular motility examination suggested that the diplopia resulted from breakdown of a small vertical phoria. CONCLUSIONS: Familial cold-induced vertical diplopia is a rare disorder of unclear etiology that need not be associated with underlying systemic disease.
Subject(s)
Cold Temperature/adverse effects , Diplopia/epidemiology , Adult , Aged , Diplopia/genetics , Diplopia/physiopathology , Distance Perception/physiology , Female , Follow-Up Studies , Genetic Predisposition to Disease , Humans , Retrospective Studies , Severity of Illness IndexABSTRACT
Lid movement and EMG of the orbicularis oculi (OOc) were analyzed in 10 patients with apraxia of lid opening associated with blepharospasm before and after botulinum toxin treatment. The latencies to onset and to complete the eye opening and the time during which eye opening was sustained were studied in relation to OOc activity and compared with control values obtained in 12 healthy subjects. Following treatment there was an improvement of all lid opening measurements, a decrease of the abnormally prolonged OOc activity, and a reduction of the functional disability.