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Biomedical subjects

E Khawam

Publications and source records attributed to E Khawam.

12 recordsLinked to original sources
PubMed2001

Bilateral asymmetric dissociated vertical deviation masquerading as unilateral double elevator palsy. A report of four cases.

PURPOSE: To illuminate this difficult clinical situation and assist and improve in its diagnosis and management. METHODS AND STUDY: Record Review. All 4 patients had a unilateral DEP and increased hyperdeviation upon tilting the head to the contralateral shoulder. Two patients had surgery to the eye with the presumed diagnosis of DEP, consisting of recession of the inferior rectus muscle in one patient and a Knapp procedure in the second patient. The other two patients had weakening surgery of the superior rectus muscle of the contralateral eye. RESULTS: The marked limitation of elevation in the eye with pseudo- DEP was either restored to normal or very satisfactorily improved. Bilateral DVD appeared in all four patients immediately after surgery. CONCLUSION: Bilateral asymmetric DVD can masquerade as unilateral DEP due to inhibitional palsy of the elevators. Meticulous diagnostic tests can reveal the DVDs.

Adolescent↗
PubMed2000

"Jampolsky Syndrome": superior rectus overaction-contracture syndrome: prevalence, characteristics, etiology and management.

BACKGROUND AND PURPOSE: To further describe the Superior Rectus Overaction/Contracture Syndrome (SRSy) first described by Jampolsky in 1964. METHODS OF STUDY: Twenty-five patients demonstrating findings characteristic of an isolated SRSy of various etiologies, but unrelated to superior oblique palsy or dissociated vertical deviation DVD, are reported. Eleven patients had surgery, consisting of superior rectus (SR) recession in ten patients and a Knapp procedure to the fellow eye (with presumed diagnosis of double elevator palsy) in one patient. RESULTS: Of the 10 patients who had SR recession of the affected eye, 9 were satisfactorily alleviated of their vertical deviation with elimination of the forced tilt difference, whereas one patient developed the SRSy in the fellow eye soon after surgery. The patient who had the Knapp procedure to the fellow eye showed, one week postoperatively, full sursumduction of that eye with significant bilateral DVD. CONCLUSION: SRSy is a common syndrome of several various etiologies. Not infrequently, whether or not associated with DVD, it may masquerade as weakness of the contralateral inferior oblique and/or superior rectus muscles. The treatment of choice is weakening of the overacting contracted SR muscle.

Adolescent↗
PubMed1998

Diagnosis and treatment of isolated inferior oblique muscle palsy: a report of seven cases.

PURPOSE: To review and report our experience in attempting to surgically eliminate the vertical deviations and the anomalous head posture in patients with inferior oblique palsy (IOP) and to add to the literature another etiology for IOP: denervation/myectomy of that muscle. SUBJECTS AND METHODS: Seven patients demonstrating findings characteristic of an isolated IOP are reported. Six were unilateral and one was bilateral. All met the Bielschowsky/Parks' Three Step Test criteria to identify an isolated IOP. Six patients had surgery that consisted of weakening the superior oblique (SO) muscle of the affected eye alone or in combination with superior rectus recession of the fellow eye. RESULTS: All patients were ultimately successfully alleviated of their vertical deviations and anomalous head postures. (Two patients developed an iatrogenic superior oblique palsy (SOP) which responded well to additional surgery.) CONCLUSIONS: The treatment of choice for IOP is tenotomy or tenectomy of the ipsilateral superior oblique muscle alone or in combination with recession of the contralateral superior rectus muscle.

Adolescent↗
PubMed1992

Post-operative return of head malposition in congenital null point nystagmus.

We present two patients with congenital null point nystagmus with head malposition and orthotopic eyes who underwent a modified Kestenbaum-Anderson operation. The face malposition returned in both patients about one year post operatively despite marked reduction of gaze toward the side of the original null point. We do not believe it is the reduced adduction of the fixating eye that eliminates the face turn or prevents its recurrence. Surgical normalization of an abnormal proprioception eliminates the face turn whereas the head malposition return is due to a faulty development of the brain, irreversible and deeply adopted to the abnormal proprioception.

Child, Preschool↗
PubMed1988

A-pattern esotropia with bilateral inferior oblique muscle overaction.

An eight-year-old boy with residual congenital esotropia, with an A-pattern and overacting inferior obliques is described. Unilateral medial rectus maximal recession and insertion supraplacement, combined with bilateral inferior oblique myectomies resulted in disappearance of the A-pattern. This is the fourth reported case of A-pattern esotropia with overacting inferior obliques. Factors related to horizontal rectus muscle function in up- and down-gazes may explain the pattern seen in this, and similar cases.

Child↗
PubMed1987

Abnormal ocular head postures: Part III.

All patients exhibiting the various types of abnormal head postures of ocular origin that were seen during the last two years are presented in order to determine the relative frequency of the different causes of these postures, and the purposes they serve. The treatment modality and results are also discussed. The manuscript is divided into four parts: Parts I, II, and III concern head postures in incomitant strabismus. In Part IV, head postures in Ciancia's syndrome, restrictions, and refractive errors are described.

Fixation, Ocular↗
PubMed1987

Abnormal ocular head postures: Part IV.

All patients exhibiting the various types of abnormal head postures of ocular origin that were seen during the last two years are presented in order to determine the relative frequency of the different causes of these postures, and the purposes they serve. The treatment modality and results are also discussed. This manuscript is divided into four parts: Parts I, II, and III concern head postures in incomitant strabismus. In Part IV, head postures in Ciancia's syndrome, restrictions, and refractive errors are described.

Adolescent↗
PubMed1987

Abnormal ocular head postures: Part I.

All patients exhibiting the various types of abnormal head postures of ocular origin that were seen during the last two years are presented in order to determine the relative frequency of the different causes of these postures, and the purposes they serve. The treatment modality and results are also discussed. The manuscript is divided into four parts: Part I, II, and III concern head postures in incomitant strabismus. In Part IV, head postures in Ciancia's syndrome, restrictions, and refractive errors are described.

Child↗
PubMed1987

Abnormal ocular head postures: Part II.

All patients exhibiting the various types of abnormal head postures of ocular origin that were seen during the last two years are presented in order to determine the relative frequency of the different causes of these postures, and the purposes they serve. The treatment modality and results are also discussed. The manuscript is divided into four parts: Parts I, II, and III concern head postures in incomitant strabismus. In Part IV, head postures in Ciancia's syndrome, restrictions, and refractive errors are described.

Duane Retraction Syndrome↗
PubMedDate not supplied

Nebulized hydromorphone for dyspnea in hospice care of advanced cancer.

This case report describes the use of nebulized hydromorphone for management of dyspnea in advanced cancer in home hospice care. The patient was intolerant of morphine; nebulized hydromorphone was used as an alternative to nebulized morphine for dyspnea and found to be both safe and effective.

Administration, Inhalation↗