An unusual variant of the dorsal midbrain syndrome in MS: clinical characteristics and pathophysiologic mechanisms

2004 ◽  
Vol 10 (3) ◽  
pp. 322-325 ◽  
Author(s):  
Elliot M Frohman ◽  
Richard B Dewey ◽  
Teresa C Frohman
Keyword(s):  
Clinical Characteristics ◽  
Ocular Motor ◽  
N Limitation ◽  
Relapsing Remitting ◽  
Midbrain Syndrome ◽  
Unusual Variant ◽  
The Right ◽  
Dorsal Midbrain Syndrome ◽  
Skew Deviation ◽  
Pathophysiologic Mechanisms

Patients with MS exhibit a broad diversity of ocular motor syndromes. We describe a patient with relapsing-remitting MS who developed an unusual variation of the dorsal midbrain syndrome, character ized by monocular convergent-retraction nystagmus in the right eye, accompanied by divergent-retraction nystagmus in the fellow eye upon attempted upward gaze. Examination also revealed a skew deviation with a left hyperdeviation and severe adductio n limitation in the left eye during attempted right gaze. We propose that a left INO accounted for the inability of the left eye to adduct (and result in convergent-retraction) during attempted upward saccades. We consider the patho physiologic mechanisms responsible for our observations and review important details of the dorsal midbrain ocular motor circuitr y.

Anti-aquaporin-4 antibody-positive dorsal midbrain syndrome

2014 ◽  
Vol 21 (4) ◽  
pp. 477-480 ◽  
Author(s):  
Juyoun Lee ◽  
Seong-Hae Jeong ◽  
Sang Min Park ◽  
Eun Hee Sohn ◽  
Ae Young Lee ◽  
...  
Keyword(s):  
Aquaporin 4 ◽  
Motor Disorders ◽  
Ocular Motor ◽  
Trochlear Nerve ◽  
Ocular Motor Disorders ◽  
Midbrain Syndrome ◽  
Trochlear Nerve Palsy ◽  
Spectrum Disorders ◽  
Aquaporin 4 Antibody ◽  
Dorsal Midbrain Syndrome

Neuromyelitis optica spectrum disorders (NMOSD) can cause various ocular motor disorders in addition to optic neuritis. Ocular motor findings associated with NMOSD include spontaneous vertical and gaze-evoked nystagmus, wall-eyed bilateral internuclear ophthalmoplegia, and trochlear nerve palsy. The association between dorsal midbrain syndrome and anti-aquaporin-4 antibody seropositivity has not been reported. Here, we report a patient displaying typical dorsal midbrain syndrome and anti-aquaporin-4 antibody seropositivity.

Neurological Impact of Wallenberg Syndrome on the Visual-Vestibular Systems

2020 ◽  
pp. 8-14
Keyword(s):  
Case Report ◽  
Left Vertebral Artery ◽  
Clinical Correlation ◽  
Ocular Motor ◽  
Eye Care ◽  
Motor Responses ◽  
Wallenberg Syndrome ◽  
Video Recordings ◽  
Binocular Diplopia ◽  
Skew Deviation

Purpose: This case discusses the neurological impact of Wallenberg syndrome on the visual-vestibular system and provides a clinical pathologic correlation between neuro-anatomic involvements with the manifesting symptoms. Case Report: A 50-year-old male presented for consultation following a left lateral medullary infarct occlusion of the left vertebral artery (Wallenberg syndrome) with complaints of intermittent binocular diplopia, vertigo, and oscillopsia. Assessment revealed an intermittent central nystagmus, a right skew deviation, and a left Horner’s syndrome. Video recordings of the nystagmus and ocular motor responses were documented. Conclusion: Wallenberg syndrome has very defined characteristics which can be used clinically to make a definitive diagnosis.It is important for eye care professionals to understand the neuro-anatomic involvements associated with this condition and make the clinical correlation to aid in the treatment and management of these patients.

Clinical characteristics and treatments of hereditary leiomyomatosis renal cell carcinoma: two case reports and literature review

2020 ◽  
Author(s):  
Dalin Feng ◽  
Mingshuai Wang ◽  
Xiaodong Zhang ◽  
Jianwen Wang
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Female Patient ◽  
Male Patient ◽  
Renal Cell ◽  
Clinical Characteristics ◽  
Genetic Test ◽  
Enhanced Ct ◽  
The Right ◽  
Hereditary Leiomyomatosis

Abstract Background The objective of this study is to discuss clinical characteristics and treatments of hereditary leiomyomatosis renal cell carcinoma on the basis of 2 cases and to review recent literature, in order to present medical advances. Methods A 29-year old male patient came to our hospital because of a huge tumour on the right kidney. Enhanced CT showed that the tumour was about 15.5*10.5 cm, and was considered to be malignant. Another case was a 38-year old female patient. She complained was found to have a right kidney tumour in a routine physical examination. Enhanced CT showed an early-stage tumour of about 4.3*3.7 cm on the lower pole of the right kidney. The male patient underwent open radical nephrectomy and the female patient underwent laparoscopic radical nephrectomy and extensive retroperitoneal lymph node dissection. The two patients underwent genetic testing and were diagnosed as having hereditary leiomyomatosis with renal cell carcinoma. Results The postoperative pathology in both patients revealed type 2 papillary renal cell carcinoma but with different prognosis. The male patient suffered multiple metastasis 10 months post-operation. The metastatic tumour of the abdominal wall was resected to confirm recurrence and hereditary leiomyomatosis renal cell carcinoma was diagnosed by the genetic test. While the female patient had a specific family history and uterine leiomyomas, the genetic test helped us to identify hereditary leiomyomatosis renal cell carcinoma pre-operation. Because of the early diagnosis and timely treatment, the female patient was considered to have a good prognosis. Conclusion Hereditary leiomyomatosis renal cell carcinoma is a rare hereditary disease resulting from FH gene mutation. There are currently no effective treatments.Our cases demonstrate that hereditary leiomyomatosis renal cell carcinoma is a very aggressive disease. Early screening and surveillance are recommended for patients with a family history or who are at risk of hereditary leiomyomatosis renal cell carcinoma. Surgical and palliative therapy still play an important role in clinical treatment.

scholarly journals Hearing Loss, Tinnitus and Pineal Germinoma: Parinaud Dorsal Midbrain Syndrome Revisited

Oncogen ◽  
2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Rithvik Marri ◽  
Harini Rao ◽  
Diana S Osorio ◽  
Jonathan L Finlay
Keyword(s):  
Hearing Loss ◽  
Midbrain Syndrome ◽  
Pineal Germinoma ◽  
Dorsal Midbrain Syndrome

Parinaud (Dorsal Midbrain) Syndrome

2018 ◽  
pp. 1318-1319
Author(s):  
Daniel E. Croft ◽  
Sumayya J. Almarzouqi ◽  
Michael L. Morgan ◽  
Andrew G. Lee
Keyword(s):  
Midbrain Syndrome ◽  
Dorsal Midbrain Syndrome

Dorsal Midbrain Syndrome

2019 ◽  
pp. 225-230
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak
Keyword(s):  
Shunt Malfunction ◽  
Upper Eyelid ◽  
Convergence Insufficiency ◽  
Common Causes ◽  
Midbrain Syndrome ◽  
Upper Eyelid Retraction ◽  
Brainstem Tumors ◽  
Ventricular Tumors ◽  
Vertical Gaze ◽  
Dorsal Midbrain Syndrome

Lesions of the dorsal midbrain produce a characteristic and highly localizing constellation of neuro-ophthalmic signs, which is known as the dorsal midbrain syndrome. In this chapter, we begin by summarizing the clinical features of the dorsal midbrain syndrome, which include supranuclear vertical gaze palsy, skew deviation, convergence insufficiency, convergence-retraction nystagmus, upper-eyelid retraction, and light-near dissociation of the pupils. We then list common causes of the dorsal midbrain syndrome, which include hydrocephalus, shunt malfunction, stroke, intrinsic brainstem tumors, and compression by extrinsic tumors, such as pineal and third ventricular tumors. Lastly, we discuss the neuro-ophthalmic features, diagnostic evaluation, and management of ventriculoperitoneal shunt malfunction.

Infective Endocarditis Presenting With Parinaud’s Dorsal Midbrain Syndrome

2006 ◽  
Vol 43 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Andrew W. Ferguson ◽  
Alice Jollands ◽  
Martin Kirkpatrick ◽  
Stuart D. Pringle ◽  
Nick D. L. George
Keyword(s):  
Infective Endocarditis ◽  
Midbrain Syndrome ◽  
Dorsal Midbrain Syndrome
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