scholarly journals Botox’s Place in the Complex Treatment of Oculomotor System Pathology (the Optimal “Portrait” of the Patient for the Chemodenervation)

2018 ◽  
Vol 15 (2S) ◽  
pp. 261-267
Author(s):  
I. L. Plisov ◽  
V. V. Cherhykh ◽  
V. V. Atamanov ◽  
N. G. Antsiferova ◽  
V. B. Pushchina ◽  
...  
Keyword(s):  
Optimal Algorithm ◽  
Cranial Nerves ◽  
Optimal Dose ◽  
Functional Results ◽  
Oculomotor System ◽  
Extraocular Muscles ◽  
Alternative Methods ◽  
Complex Treatment ◽  
Patients Âgés ◽  
Results Of Treatment

Introduction. To summarize our fifteen-years clinical experience of using Botox in strabismology and determine the indications for the most effective use of chemodenervation in the complex treatment of oculomotor system pathology.Patients and methods. To carry out chemodenervation of extraocular muscles, Botox was used. The optimal dose of Botox for intramuscular injection ranged from 1.25 to 5.0 units. The choice of dosage depends on the patient’s age, the type oculomotor system pathology, the level of muscular dysfunction and the purpose of the treatment. The treatment was performed in 376 patients with various disorders of oculomotor system. At the time of treatment, the patients’ ages ranged from 12 to 78 years. Injection of Botox into the extraocular muscles in all cases was the primary method of treatment.Results. In general, the state of relative functional recovery was achieved in 71.81% of cases (in 270 patients). The best results were obtained in treatment of decompensated heterophories, acute heterotrophies, atypical heterotrophies and primary hyperfunction of the inferior oblique muscles (in 100% of cases). In these conditions, the binocular vision was preserved in patients, and the imbalance of the oculomotor system did not show any sign of incomitance. However, patients with paralysis and paresis of the cranial nerves chemodenervation allowed creating conditions for a more complete restoration of muscular functions, to avoid the occurrence of a secondary imbalance in the oculomotor system. In 70.3% cases (185 patients), subsequent surgical treatment was not required. Reliable functional results of treatment allowed creating the optimal algorithm for chemodenervation.Discussion. Chemodenervation of extraocular muscles is an effective independent and additional method of complex treatment of oculomotor system pathology and expands opportunities in patients’ rehabilitation. To achieve maximum functional results, it is necessary to select patients correctly for this procedure, taking into account its appropriateness and advantages over alternative methods of treatment, selection of optimal dosages of Botox. 

Evaluation clinical efficacy of immunotherapy in complex treatment of acute optic neuritis associated with herpesvirus infection

2021 ◽  
pp. 167-171
Author(s):  
D.А. Povalyaeva ◽  
◽  
V.V. Egorov ◽  
G.P. Smoliakova ◽  
L.P. Danilova ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Clinical Efficacy ◽  
Irrigation System ◽  
Functional Results ◽  
Complex Treatment ◽  
Herpesvirus Infection ◽  
Results Of Treatment ◽  
Acute Optic Neuritis ◽  
Key Words Optic Neuritis ◽  
Retrobulbar Space

Purpose. To study the clinical efficacy of complex treatment of optic neuritis (ON) associated with herpesvirus infection (HVI), including methods of immunotherapy. Material and methods. The clinical study involved 37 people (37 eyes) with acute ON associated with HVI. The treatment regimen for all patients within 10 days included delivery through irrigation system implanted into the retrobulbar space to optic nerve: solutions Dexamethasone on decreasing scheme, Emoxypine 1% 0.5 ml and Dicynone 12.5% 0.5 ml, in combination with administration of drugs neuroprotection. All patients were divided into 2 groups depending on characteristics of therapy. The 1st group consisted of 17 patients, who were treated according to the standard method. 2nd group consisted of 20 patients who received additional intramuscular Imunofan in the regimen and doses according to the manufacturer's instructions. Results. Analysis of obtained datas showed that more significant positive dynamics was noted in the clinical course of ON in patients of the 2nd group of observation in comparison with the 1st group. Conclusion. The strategy of etiotropic and pathogenetic immunotherapy at ON, associated with HVI infection, developed by us, allows to shorten recovery time and improve functional results of treatment in absence of relapses of disease within 1 year of follow-up. Key words: optic neuritis, herpesvirus infection, corticosteroid therapy, immunotherapy.

The fate of the oculomotor system in clinical bilateral anophthalmia

2012 ◽  
Vol 29 (3) ◽  
pp. 193-202 ◽  
Author(s):  
HOLLY BRIDGE ◽  
NICOLA RAGGE ◽  
NED JENKINSON ◽  
ALAN COWEY ◽  
KATE E. WATKINS
Keyword(s):  
Optic Nerve ◽  
High Resolution ◽  
Muscle Development ◽  
Cranial Nerves ◽  
Abducens Nerve ◽  
Oculomotor System ◽  
Extraocular Muscles ◽  
Oculomotor Nerve ◽  
Neuromuscular System ◽  
Very High

AbstractThe interdependence of the development of the eye and oculomotor system during embryogenesis is currently unclear. The occurrence of clinical anophthalmia, where the globe fails to develop, permits us to study the effects this has on the development of the complex neuromuscular system controlling eye movements. In this study, we use very high-resolution T2-weighted imaging in five anophthalmic subjects to visualize the extraocular muscles and the cranial nerves that innervate them. The subjects differed in the presence or absence of the optic nerve, the abducens nerve, and the extraocular muscles, reflecting differences in the underlying disruption to the eye’s morphogenetic pathway. The oculomotor nerve was present in all anophthalmic subjects and only slightly reduced in size compared to measurements in sighted controls. As might be expected, the presence of rudimentary eye-like structures in the socket appeared to correlate with development and persistence of the extraocular muscles in some cases. Our study supports in part the concept of an initial independence of muscle development, with its maintenance subject to the presence of these eye-like structures.

Immunotherapy in complex treatment of acute optic neuritis associated with herpesvirus infection

2021 ◽  
pp. 339-343
Author(s):  
D.А. Povalyaeva ◽  
◽  
V.V. Egorov ◽  
G.P. Smoliakova ◽  
L.P. Danilova ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Irrigation System ◽  
Functional Results ◽  
Complex Treatment ◽  
Herpesvirus Infection ◽  
Results Of Treatment ◽  
Acute Optic Neuritis ◽  
Key Words Optic Neuritis ◽  
Retrobulbar Space

Purpose. Evaluation clinical efficacy of complex treatment of optic neuritis (ON) associated with herpesvirus infection (HVI), including methods of immunotherapy. Material and methods. The clinical study involved 26 people (26 eyes) with acute ON associated with HVI. The treatment regimen for all patients within 10 days included delivery through irrigation system implanted into the retrobulbar space to optic nerve: solutions Dexamethasone on decreasing scheme, Emoxypine 1% 0.5 ml and Dicynone 12.5% 0.5 ml. All patients were divided into 2 groups depending on characteristics of therapy. The 1st group consisted of 12 patients, who were treated according to the standard method. 2nd group consisted of 14 patients who received additional intramuscular Imunofan. The duration of immunotherapy was 10–12 days. Results. Analysis of obtained datas showed that more significant positive dynamics was noted in the clinical course of ON in patients of the 2nd group of observation in comparison with the 1st group. Conclusion. The developed strategy of etiotropic and pathogenetic immunotherapy at ON associated with HVI infection, allows shortening recovery time and improving functional results of treatment in absence of relapses of disease within 1 year of follow-up. Key words: optic neuritis, herpesvirus infection, corticosteroid therapy, immunotherapy.

scholarly journals Extraocular Muscles Tension, Tonus, and Proprioception in Infantile Strabismus: Role of the Oculomotor System in the Pathogenesis of Infantile Strabismus—Review of the Literature

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Costantino Schiavi
Keyword(s):  
Critical Period ◽  
Muscle Force ◽  
Sensory System ◽  
Oculomotor System ◽  
Extraocular Muscles ◽  
Review Of The Literature ◽  
Eye Muscle ◽  
System A ◽  
Concomitant Strabismus

The role played by the extraocular muscles (EOMs) in the etiology of concomitant infantile strabismus is still debated and it has not yet definitively established if the sensory anomalies in concomitant strabismus are a consequence or a primary cause of the deviation. The commonest theory supposes that most strabismus results from abnormal innervation of the EOMs, but the cause of this dysfunction and its origin, whether central or peripheral, are still unknown. The interaction between sensory factors and innervational factors, that is, esotonus, accommodation, convergence, divergence, and vestibular reflexes in visually immature infants with family predisposition, is suspected to create conditions that prevent binocular alignment from stabilizing and strengthening. Some role in the onset of fixation instability and infantile strabismus could be played by the feedback control of eye movements and by dysfunction of eye muscle proprioception during the critical period of development of the visual sensory system. A possible role in the onset, maintenance, or worsening of the deviation of abnormalities of muscle force which have their clinical equivalent in eye muscle overaction and underaction has been investigated under either isometric or isotonic conditions, and in essence no significant anomalies of muscle force have been found in concomitant strabismus.

scholarly journals Questions of complex treatment of extensive small pelvis phlegmons in patients with diabetes mellitus

2019 ◽  
Vol 41 part 3 (2) ◽  
pp. 21-24
Author(s):  
N. N. Veligotskiy ◽  
A. S. Trushin ◽  
A. I. Seroshtanov ◽  
A. A. Sheptukha ◽  
I. Ye. Bugakov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
Complex Treatment ◽  
Ozone Therapy ◽  
Treatment Results ◽  
Results Of Treatment ◽  
Patients With Diabetes

The complex treatment results of 127 patients with extensive purulent processes in diabetes mellitus that were treated in our clinic with ozone therapy and ultrasonic cavitations at 2001–2018 are presents. The problems of the course of the disease and the aggravating influence of the accompanying pathology on it are noted. The options improving the results of treatment considered.Keywords: phlegmon, small pelvis, diabetes mellitus, multiple organ failure, ozone therapy, cavitations.

scholarly journals Therapeutic tactics in the deep forms of rectal abscesses complicated by fournie gangrene

2020 ◽  
Vol 73 (2) ◽  
pp. 293-297
Author(s):  
Oleh E. Kanikovskyi ◽  
Andrii V. Osadchyі ◽  
Sergey I. Androsov ◽  
Anatolii V. Tomashevsky ◽  
Oleh A. Yarmak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Antibacterial Therapy ◽  
Treatment Duration ◽  
Complex Treatment ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Surgical Clinic ◽  
Modern Technologies ◽  
Clinical Emergency ◽  
Early Surgical Treatment

The aim: To conduct an analysis of the complex treatment of severe forms of rectal abscesses complicated by NF. Materials and methods: The results of treatment in 471 patients with deep forms of RA was performed. In 38(8%) the spread of the process and rotten-necrotic affection of the perineal fascia. Patients were treated at the surgical clinic of the medical faculty №2, VNPMMU, and Vinnytsya Clinical Emergency Hospital in the period from 2010-2018. Results: Total lethality 8(1,7%). Mortality in GF was 8(19,5%). It is worth noting the reduction of the treatment duration against the background of the modern technologies usage in the period from 2016 to 12 days in relation to the total figure of 15 days. Conclusions: Early surgical treatment, adequate necrectomy, fasciotomy and antibacterial therapy stop the necrotic process. The active aspiration reduces the timing of wound cleansing and further ensures the accelerated implementation of reconstructive surgical interventions.

The use of Dimexide in the complex treatment of Peyronie's disease

1980 ◽  
Vol 61 (6) ◽  
pp. 53-54
Author(s):  
M. G. Muhamadeev ◽  
M. P. Trofimova
Keyword(s):  
Clinical Manifestations ◽  
Disease Recurrence ◽  
Peyronie’S Disease ◽  
Long Term Results ◽  
Complex Treatment ◽  
Results Of Treatment ◽  
Peyronie's Disease

We observed 9 patients with plastic induration of the penis (Peyronie's disease), 3 of them interrupted treatment. Long-term results of treatment were traced in 6 patients (age - from 48 to 60 years): in 5 patients, complaints and clinical manifestations of disease recurrence were not noted for 2-4 years.

EFFECTІVENESS OF LASER THERAPY ІN COMPLEX TREATMENT OF HERPETIC STOMATITIS

2021 ◽  
Vol 74 (6) ◽  
pp. 1331-1335
Author(s):  
Yulia G. Kolenko ◽  
Tetiana O. Timokhina ◽  
Nina S. Khrol ◽  
Oksana V. Kononova ◽  
Olesya V. Lynovytska
Keyword(s):  
T Lymphocytes ◽  
Laser Therapy ◽  
Pain Syndrome ◽  
Control Group ◽  
Complex Treatment ◽  
Results Of Treatment ◽  
Clinical Observations ◽  
Immunological Tests ◽  
T Helpers ◽  
Positive Effect

The aim: The purpose of research is to improve the effectiveness of treatment by applying laser in complex treatment in patients with herpetic stomatitis. Materials and methods: Were examined 47 people (22 men and 25 women) with acute herpetic stomatitis. The patіents’ age was from 20 to 72 years. All patients underwent immunological tests such as (T-lymphocytes (CD3 +), T-helpers (CD4 +), cytotoxic T-lymphocytes (CD8 +), the content of immunoglobulins IgM, IgG, IgA and slgA in saliva to assess the іmmunological reactivity of the organism. Results: Clinical observations have shown that when using laser therapy, the results of treatment were better than in the control group. Positive dynamics was observed as early as 1-2 days after the start of laser use and was more pronounced when used in the early stages of the disease. The use of the laser promoted a more rapid suspension of new lesions, a decrease in pain syndrome, and a more rapid regression of herpetic lesions. We have found significant improvements in the arameters of cellular and humoral іmmunity in patients of the main group. Conclusions: Treatment of herpetic stomatitis is relevant and requires further improvement and the search for new methods. The use of a laser in the complex treatment of herpetic stomatitis has a positive effect on the course and іmmunological status of patients with herpetic stomatіtis. The manifestations of the disease healed faster, and the pain syndrome was less severe. Duration between іllness and treatment decreased on 19.7% and 26%. It is advіsable to include the method of treatment using a laser in the complex therapy of herpetic stomatitis.

The Extraocular Muscles and Diplopia

2014 ◽  
pp. 124-161
Author(s):  
Shirley H. Wray ◽  
Shirley H. Wray
Keyword(s):  
Eye Movements ◽  
Nerve Palsy ◽  
Neuromuscular Junctions ◽  
Cranial Nerves ◽  
Abducens Nerve ◽  
Extraocular Muscles ◽  
Oblique Muscle ◽  
Oculomotor Nerve Palsy ◽  
Subjective Complaint ◽  
Oculomotor Nuclei

deals with action and innervation of the extraocular muscles. In their intact state, the extraocular muscles and the cranial nerves that innervate them are responsible for every movement of the eyes signaled by the cortex. Diplopia, or double vision, is the commonest subjective complaint associated with a lesion affecting the extraocular muscles, their neuromuscular junctions, the oculomotor nuclei or nerve, or pathways in the brainstem that maintain alignment of the eyes. The diplopia history focuses on distinguishing monocular from binocular diplopia and the diplopia examination pays attention to head position, ocular alignment, and the range of eye movements during monocular and binocular viewing as keys to diagnosis. Diplopia with full eye movements is fully discussed. Four illustrative cases are presented: episodic diplopia due to ocular myasthenia gravis; a case of esotropia (paresis of the lateral rectus with inward deviation of the eye) due to an abducens nerve palsy; a case of exotropia (paresis of the medial rectus with outward deviation of the eye) due to a fascicular oculomotor nerve palsy; and a case of hypertropia (vertical misalignment of the eyes due to paresis of the superior oblique muscle vs. skew deviation) caused by a post-traumatic trochlear nerve palsy.

Nonvestibular Schwannomas of the Brain: A 7-Year Experience

Neurosurgery ◽  
2002 ◽  
Vol 50 (3) ◽  
pp. 437-449 ◽  
Author(s):  
Sajjan Sarma ◽  
Laligam N. Sekhar ◽  
David A. Schessel
Keyword(s):  
Tumor Resection ◽  
Cranial Nerves ◽  
Abducens Nerve ◽  
Functional Results ◽  
Senior Author ◽  
Karnofsky Performance Scale ◽  
Lumbar Drain ◽  
Scale Scores ◽  
The Brain

Abstract OBJECTIVE: Nonvestibular schwannomas are uncommon tumors of the brain. Trigeminal nerve schwannomas are the most common of this group, followed by glossopharyngeal, vagal, facial, accessory, hypoglossal, oculomotor, trochlear, and abducens nerve schwannomas, in descending order of frequency. We present a series of nonvestibular schwannomas that were surgically treated during a 7-year period. METHODS: Forty-six patients with schwannomas of Cranial Nerves V (26 cases), VII (7 cases), IX, X, and XI (9 cases), XII (3 cases), and III (1 case) were microsurgically treated by the senior author (LNS) during a 7-year period, from 1993 to 2000. The clinical presentations, operative approaches, complications, and results were studied. RESULTS: Forty-five patients underwent gross total tumor resection in the first operation. One patient who had undergone subtotal tumor resection in the initial operation experienced a large recurrence after 4 years, and gross total tumor resection was achieved in the second operation. There were no postoperative deaths. Postoperative morbidity consisted of cerebrospinal fluid leaks for 5 patients (3 patients required a second operation to repair the leak, and 2 patients responded to lumbar drain placement), meningitis for 3 patients (2 cases were aseptic and 1 involved bacterial meningitis, which resolved with antibiotic therapy), vasospasm requiring angioplasty for 1 patient, temporary hemiparesis for 2 patients (who experienced good recoveries), and permanent hemiparesis for 1 patient. New cranial nerve deficits were observed for 24% of patients but were usually partial. The mean follow-up period was 33.3 months (range, 0.2–93 mo). No patient experienced tumor recurrence after complete tumor removal. The patient who experienced regrowth of the tumor did not exhibit recurrence after the second operation. The Karnofsky Performance Scale scores at the latest follow-up examination were 80 or more for 45 patients (98%) and 70 for 1 patient. CONCLUSION: Nonvestibular schwannomas can be treated via microsurgical excision, with excellent functional results. Recurrence is rare after total tumor excision, although much longer follow-up monitoring is required.

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