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Biomedical subjects

M L Slavin

Publications and source records attributed to M L Slavin.

At least 19 recordsLinked to original sources
PubMed1996

Abduction defect associated with aberrant regeneration of the oculomotor nerve after intracranial aneurysm.

PURPOSE: To determine the cause of delayed-onset ipsilateral abduction defect associated with aberrant regeneration of the oculomotor nerve. METHODS: Isolated oculomotor palsy was noted after successful basilar artery aneurysm surgery in a 35-year-old patient. Several months later, aberrant regeneration of the oculomotor nerve and an ipsilateral abduction defect were first detected. RESULTS: Ocular electromyography demonstrated failure of relaxation of the ipsilateral medial rectus muscle on attempted abduction, suggesting cocontraction of horizontal recti muscles as the origin of the abduction defect. CONCLUSION: A late-onset ipsilateral abduction defect caused by failure of relaxation of the medial rectus muscle may be associated with basilar aneurysm.

Adult↗
PubMed1994

Visual loss caused by choroidal ischemia preceding anterior ischemic optic neuropathy in giant cell arteritis.

Three patients with visual loss and normal fundi were discovered to have choroidal ischemia on fluorescein angiography. Each patient had a markedly increased Westergren erythrocyte sedimentation rate, but only one described symptoms of polymyalgia rheumatica, neck pain, and jaw claudication. Biopsy of the temporal artery confirmed giant cell arteritis in the two patients without constitutional symptoms. In one patient, typical anterior ischemic optic neuropathy developed the following day, whereas in the other two, anterior ischemic optic neuropathy later occurred despite the prompt administration of intravenous high-dose corticosteroids. Choroidal ischemia may be the first sign of giant cell arteritis in elderly patients with visual loss. Early diagnosis and treatment are mandatory in an attempt to forestall the development of anterior or posterior ischemic optic neuropathy, or central retinal artery occlusion in the affected or fellow eye.

Aged↗
PubMed1993

Chiasmal compression from fat packing after transsphenoidal resection of intrasellar tumor in two patients.

After transsphenoidal resection of a pituitary (or other) tumor, the remaining intrasellar cavity, and sphenoid sinus are usually packed with exogenous fat or muscle to prevent cerebrospinal leak and prolapse of the optic chiasm into an empty sella. We treated two patients in whom chiasmal compression occurred postoperatively because of packing of fat. In one patient, the expected visual improvement in the postoperative period was suboptimal. The subsequent removal of fat resulted in total visual recovery. In the other patient, chiasmal compression persisted from intrasellar fat and residual tumor. Iatrogenic compression of the optic nerves or chiasm should be considered in all patients in whom visual recovery is incomplete.

Adipose Tissue↗
PubMed1992

Ocular manifestations of Mycoplasma pneumoniae infection.

Ocular manifestations of Mycoplasma pneumoniae infection, other than conjunctivitis, are uncommon. Optic disk swelling, optic nerve atrophy, retinal exudates and hemorrhages, and cranial nerve palsies have been infrequently reported. We describe a 15-year-old patient who developed bilateral optic disk edema and iritis during an acute infection with M. pneumoniae and review the world literature on findings associated with ocular manifestations of infection with this pathogen. Although our patient experienced complete resolution of iritis and optic disk edema after 6 weeks, several patients described in the literature have experienced permanent sequelae as a result of optic neuropathy.

Adolescent↗
PubMed1992

Thyroid ophthalmopathy presenting as superior oblique paresis.

Six patients with thyroid ophthalmopathy presented with what appeared to be a unilateral superior oblique paresis by the three-step test, which was eventually followed by more typical findings of thyroid disease. This early motility defect in thyroid ophthalmopathy may be caused by a restrictive process due to involvement of the inferior rectus muscle. Clues to the proper diagnosis included an increase in vertical deviation in upgaze, elevation of intraocular tension in upgaze, and the lack of excyclodeviation. These features should be assessed in patients with isolated superior oblique paresis.

Adult↗
PubMed1990

The prism dissociation test in detecting unilateral functional visual loss.

The prism dissociation test is useful in quantifying visual acuity in an eye with functional unilateral visual loss, whether severe or mild in degree. A small vertical prism is used to induce diplopia of a 20/20 or larger size projected Snellen letter, and the patient is asked to comment on the quality of each image seen. The acknowledgement of diplopia and comments on the clarity of the dissociated images serve as testimony to the actual level of visual acuity in each eye. In one case, a patient feigned 20/50 visual acuity in one eye after trauma. The prism dissociation test confirmed visual acuity of 20/20 in that eye, as well as excluding an abnormality of contrast sensitivity. In another case, an amblyopic eye previously noted to have 20/30 visual acuity, which allegedly had acute severe visual loss, was documented to have 20/30 visual acuity by the prism dissociation test.

Diplopia↗
PubMed1989

Hyperdeviation associated with isolated unilateral abducens palsy.

Sixteen patients with isolated unilateral abducens palsy were found to have an associated hyperdeviation (HD) in peripheral gaze on Maddox rod examination. In four patients, the chief complaint was vertical as well as horizontal diplopia. Vertical ductions were normal in each case and the maximal HD ranged from 8 to 16 prism diopters (PD) in 10 of 16 patients (62.5%) and from 4 to 7 PD in 6 of 16 patients (37.5%). In ten cases, an HD in primary as well as peripheral gaze was detected. The magnitude of HD did not correlate with the degree of abduction defect, and the HD was maximal to the side of the paretic lateral rectus muscle in 14 of 16 cases, with 2 cases greatest on direct lateral gaze; 6 cases, lateral upgaze; and 6 cases, lateral downgaze. The Bielschowsky head tilt test was positive in 1 of 14 cases, and the double Maddox rod test showed the absence of cyclodeviation in 10 of 12 cases tested. A variable HD was present in six cases. In two cases, up and downshooting of the paretic eye, respectively, was noted on attempted abduction. The HD diminished in synchrony with abduction improvement. Mechanical factors and vertical substitution movements may explain the HD.

Abducens Nerve↗
PubMed1989

Eyelid swelling and erythema as the only signs of subperiosteal abscess.

On clinical grounds it is usually easy to distinguish between preseptal cellulitis, a cutaneous infection not threatening to vision, and orbital cellulitis, a potentially vision threatening infection of the orbital tissues generally arising from paranasal sinusitis. We recently cared for two patients with a clinical diagnosis of preseptal cellulitis who had CT scan evidence of subperiosteal abscess. Antibiotic therapy alone resulted in clinical resolution in each case.

Abscess↗
PubMed1989

Metastatic malignant meningioma.

The onset of a rapidly progressive abducens and trigeminal neuropathy, third-order neuron Horner's syndrome, and decreased lacrimation clinically suggest a malignant lesion at the base of the middle cranial fossa, commonly a metastatic process. A case is reported in which computed tomography and magnetic resonance imaging failed to image the lesion but a bone scan clearly depicted the abnormal area. A malignant meningioma (en plaque) was evident on biopsy, and pulmonary metastases later ensued. Common histological patterns of meningioma (often thought of as a benign tumor) include meningothelial, fibrous, and transitional types. The association of cellular atypia, nuclear pleomorphism, marked mitoses, and brain invasion warrants the designation of malignant meningioma. The incidence of malignancy in meningioma ranges from 2 to 10% with reported metastases occurring in 0.1%.

Abducens Nerve↗