SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
We report a case of Mycoplasma pneumoniae meningoencephalitis in which the primary neurologic manifestation was diplopia. Other neurologic findings included bilateral Babinski signs, mental confusion, and bladder incontinence. The patient responded to a course of minocycline and made an uneventful recovery. We report the first known case of Mycoplasma meningoencephalitis with diplopia.
We report, to our knowledge, the first case of a patient experiencing recalcitrant diplopia after implantation of a Krupin valve with disc for uncontrolled glaucoma. Despite multiple surgeries and adjustments in her glasses, the patient was left with residual and intolerable diplopia.
The symptoms and findings of three patients with clivus chordomas who had episodes of intermittent diplopia are presented. The causes of intermittent diplopia are reviewed, and the possible mechanisms of this symptom in chordomas are discussed.
Two patients are presented with diplopia after cataract extraction performed under local anesthesia. Since there was no spontaneous recuperation after several months, strabismus surgery was performed. The first patient presented a restriction of the inferior rectus muscle probably caused by the retrobulbar injection of anesthetics. The second patient had a decompensation of a congenital superior oblique palsy. A survey of the different etiologies of diplopia after cataract surgery is given.
We reported 2 cases of multiple images of cerebral origin. Case 1 was a 26-year-old right-handed woman, who showed a defect in the peripheral part of right visual field, with photopsia in the defective field, and cerebral diplopia within the perimetry-determined preserved part of the right hemifield. This was associated with a small infarction in the deep and anterior part of the area 17. The phenomenon was well-illustrated by her own detailed drawing. Case 2 was a 67-year-old right-handed man, who, following a hypoxic accident, developed monocular triplopia. MRI revealed laminar necrosis in the areas 18 and 19 bilaterally. Triplopia was reproducible when he fixed his attention upon the circumscribed afterimage given by a strobo-flash. This would serve as counterevidence against the Bender's hypothesis that this phenomenon was caused by the pseudofovea. In both cases, multiple images occurred only to objects upon which they fixed their gaze, only in the specific sector of the visual field. Both experienced diplopia and triplopia only after a few seconds of fixation. When they turned away the gaze, the extraimages disappeared. We proposed a new hypothesis for this phenomenon, i.e., it is caused by the impaired lateral inhibition, selective to the magnocellular system in the area 17 or other early visual cortices.
In patients with obligate fixation disparity central objects may be perceived as double when peripheral fusion is achieved. The diplopia cannot be resolved with prisms because the fusional power of the periphery is stronger than the central power. A different cortical integration of the peripheral and central parts of the retina is thought to be the underlying cause. We report on the clinical findings in a 45-year-old man with macular dystrophy who complained of binocular vertical diplopia of up to 1 degree. Investigation with the phase-difference haploscope revealed inhomogeneous retinal correspondence in the vertical plane, with a displacement of the visual field center relative to the periphery by 0.6 degrees. We suggest that paracentral scarring had caused displacement of receptors such that the center and the periphery could not be fused simultaneously. The case represents a model for a retinal origin of fixation disparity.
Diplopia is a symptom that may be the result of paralytic strabismus. The causes of paralytic strabismus are deficiencies of cranial nerves III, IV, or VI. When encountering neurogenic diplopia, the clinician must determine which ocular motor nerve is involved. The clinician must then decide whether the disturbance is in the nerve nucleus, its fascicles, along the course of the nerve in the subarachnoid space, in the cavernous sinus, or at its termination within the orbit. With proper diagnosis, identification, and localization, appropriate management may be undertaken.
PURPOSE: Two cases illustrate the symptoms, signs, etiologies, and treatment of ocular neuromyotonia (ONM). METHODS: The histories, neuroradiologic tests, and/or biopsy revealed the etiologies of ONM in both patients. Clinical observations, videotaping, and electronic eye movement recordings documented the eye movements. RESULTS: A 72-year-old man with chronic arachnoiditis following myelography with thorium dioxide (Thorotrast) developed intermittent diplopia and a partial right third nerve palsy. Left gaze induced spasm of the right medial rectus. Right gaze produced right lateral rectus spasm. A 66-year-old woman, who had radiation treatment for a pituitary tumor and acromegaly, had intermittent spasm of the left medial rectus muscle and left esotropia. The episodes occurred spontaneously and were induced by right gaze. A left internuclear ophthalmoplegia was also found. Carbamazepine (Tegretol) abolished the ONM in both patients. CONCLUSIONS: Although ONM is an unusual cause of intermittent diplopia and strabismus, its distinctive clinical features identify it. Injury to the peripheral cranial nerves probably leads to segmental demyelination, axonal hyperexcitability, and a self-perpetuating, reverberating circuit, which causes spasms of the extraocular muscles.
Dural fistulas of the cavernous sinus represent a relatively unknown etiology for diplopia. The authors report on a case where combination of MR and transcranial Doppler (especially transocular) helped in diagnostic and therapeutic approach. They propose a new algorithm for the management of diplopia.
Although depth is experienced with targets at large disparities when they are seen as double or diplopic, whether that depth is as direct as with fused targets has been a matter of considerable uncertainty. Researchers have often claimed that judgments of the depth of diplopic targets during simple near/far tasks rely upon indirect associations with eye-muscle proprioception or a copy of the vergence drive signal. We designed a four-alternative task that could not be performed without a direct appreciation of depth. Observers judged the depths of each of two Gabor stereo pairs presented simultaneously. Disparities were always above each observer's measured diplopia threshold. The signs of the disparities were varied independently and observers reported the perceived depth near and far for each target. Our results demonstrate conclusively that depth during diplopia requires neither proprioception nor an efferent copy but is direct.
PURPOSE: The aim of the study is to evaluate results of surgical treatment of strabismus and diplopia in Graves-Basedow ophthalmopathy. MATERIAL AND METHODS: The surgical procedure was performed in 40 patients with horizontal strabismus, horizontal strabismus with vertical deviation or isolated vertical strabismus. There were performed 86 surgical procedures on the eye muscles (in 20 cases adjustable sutures were used). RESULTS: Recovery or recovery without binocular single vision was observed in 27 cases (67.5%) and improvement in 11 cases (27.5%). CONCLUSIONS: The necessary conditions of surgical treatment are stabile euthyreoid state, the stabilization of the angle of strabismus and diplopia. The best results of operation are in the prefibrosis period of the muscle directly. The surgical procedures of weakening the function of muscles and adjustable sutures are recommended. The operations of several stages and atraumatic should be performed.
The third and fourth fingertips of five subjects were pressed against each other so as to produce a skin displacement. A single spherical stimulus was then applied simultaneously to the two fingertips in order to test perceptual experiences with different amounts of skin displacement. The results show that the probability of detecting one stimulus when a single stimulus was applied to the skin in the resting position was 0.90. This probability decreased with increments in skin displacement. At the maximum skin displacement tested the probability of detecting one stimulus when a single stimulus was applied to the two displaced fingertip surfaces was only 0.04: this means that the single stimulus was perceived to be double with a probability of 0.96. The occurrence of this doubling, similar to Aristotle's crossed-finger illusion, shows that a diplopia-like phenomenon is present in the somesthetic system. How this 'tactile diplopia' could represent an interesting approach to the study of tactile perception is discussed.
In 21 patients with traumatic diplopia, oculomyodynamometry (OMD) was used to examine the force of the extrinsic ocular muscles. In nine patients with blow-out fracture of the orbit, the greatest impairment in the active force and function of the incarcerated muscle was found in linear fractures. In 12 cases of traumatic paresis of the cranial nerves, OMD enabled the degree of paresis of particular extraocular muscles to be assessed, was helpful in establishing a correct diagnosis as well as prognosis for the restoration of function of the affected muscles, and provided data useful in planning the operative procedure.
In a follow-up study of 124 patients with fractures of the zygoma, 100 of whom had undergone surgery, sensory disturbances of the intraorbital nerve, mostly to a very moderate degree, were found in 46% of those operated on. Slight imperfections of the fracture reduction had no influence on the results, and no substantial difference in outcome was found between the different surgical methods employed. The diplopia that persisted in five patients was due to reduced motility of the globe, without any displacement or sign of loss of orbital contents.
Although neurological complications are common in patients undergoing allogeneic bone marrow transplant (alloBMT), cavernous sinus thrombosis (CST) has rarely been described. An allograft recipient is described who presented with diplopia and developed CST in the early post-transplant period likely caused by a filamentous fungus. Clinical course and serial radiological studies of this patient are described and correlated with autopsy findings.
Idiopathic giant cell myocarditis is a rare and frequently fatal inflammatory heart disease which leads to congestive heart failure or ventricular arrhythmias. It is often associated with other autoimmune disorders. We report a 39-year-old woman who first presented with diplopia and painful eye movements, the typical clinical picture of orbital myositis. Shortly afterwards, she developed rapidly progressive congestive heart failure due to giant cell myocarditis, which took a fatal course within some weeks. Autopsy confirmed both disorders. This case report underlines the importance of early and repeated monitoring of cardiac function, if orbital myositis is suspected, in order to consider cardiac transplantation, the only efficacious treatment of giant cell myocarditis, in time.
BACKGROUND: Vertical diplopia after blow out fracture repair is not uncommon; we report an unusual case of inferior rectus muscle (IR) transection presenting as a persistent infra-duction deficit after uncomplicated blow out fracture repair. METHODS: We used multi-positional MRI to diagnose a transected IR with a contracted and posteriorly displaced muscle belly. RESULTS: Infra-duction improved after surgical repair of the transected IR. CONCLUSION: Multipositional MRI is a novel technology that can be used to assist in the decisive management of persistent post-operative infra-duction deficits and avoid prolonged periods of observation.
Isolated true aneurysm of the subclavian artery is rare and can rupture, thrombose, embolize, or cause symptoms by local compression. We describe a case of a 67-year-old man with proximal left subclavian artery aneurysm presenting with hemoptysis, hoarseness, and diplopia. These symptoms suggested that the aneurysm ruptured, that the left recurrent laryngeal nerve was compressed by it, and that its mural thrombus caused cerebral embolism. It was incidentally confirmed that the aneurysm grew at the rate of 1.31 cm/year, from 3.0 to 4.2 cm in diameter for 11 months, preciously measured in a computed tomography scan. The aneurysm was successfully repaired via partial cardiopulmonary bypass and separate perfusion of the left common carotid artery through cross-clamping the descending thoracic aorta and the aortic arch between the origins of the brachiocephalic artery and the left common carotid artery. Neither partial clamping of the aortic arch at the portion branching the left subclavian artery nor taping the aortic arch between the origins of the left common carotid artery and the left subclavian artery could be achieved.