The oculomotor (third) cranial nerve arises from the upper part of the mesencephalon (midbrain). It carries both a somatic efferent (motor) supply to some of the extra-ocular muscles and a general visceral efferent (parasympathetic) supply to the sphincter pupillae and ciliaris muscles. Its contribution to the pupillary light reflex represents an important aspect of its function and is an essential component of the evaluation of neurological patients. This paper reviews the neuroclinical aspects of the nerve�s anatomy and and provides easily understandable guidance to an effective assessment of its dysfunction. The contributions of the third cranial nerve to pupillary reaction to light, the changes in pupillary size reflecting the various stages of its dysfunction in intracranial pathologies, and its association with neurotrauma as well as some of the eponymous syndromes associated with it are discussed.
{"title":"Neuroclinical Anatomy of the third Cranial Nerve","authors":"T. B. Rabiu","doi":"10.5580/880","DOIUrl":"https://doi.org/10.5580/880","url":null,"abstract":"The oculomotor (third) cranial nerve arises from the upper part of the mesencephalon (midbrain). It carries both a somatic efferent (motor) supply to some of the extra-ocular muscles and a general visceral efferent (parasympathetic) supply to the sphincter pupillae and ciliaris muscles. Its contribution to the pupillary light reflex represents an important aspect of its function and is an essential component of the evaluation of neurological patients. This paper reviews the neuroclinical aspects of the nerve�s anatomy and and provides easily understandable guidance to an effective assessment of its dysfunction. The contributions of the third cranial nerve to pupillary reaction to light, the changes in pupillary size reflecting the various stages of its dysfunction in intracranial pathologies, and its association with neurotrauma as well as some of the eponymous syndromes associated with it are discussed.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129825381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present a case of severe vomiting in a two year old girl complicated by respiratory aspiration and death following the first dose of liquid glycopyrrolate via her gastrostomy. She had history of vomiting after treatment with hyoscine patches.Our objective is to evaluate if Glycopyrrolate can cause severe vomiting with serious consequences, and to establish the risk in clinical practice.
{"title":"Is it Glycopyrrolate? A Case report","authors":"M. Hameed, K. Shah","doi":"10.5580/16c0","DOIUrl":"https://doi.org/10.5580/16c0","url":null,"abstract":"We present a case of severe vomiting in a two year old girl complicated by respiratory aspiration and death following the first dose of liquid glycopyrrolate via her gastrostomy. She had history of vomiting after treatment with hyoscine patches.Our objective is to evaluate if Glycopyrrolate can cause severe vomiting with serious consequences, and to establish the risk in clinical practice.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133949307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frontal lobotomy, a form of psychosurgery popular in the 1930s to 1950s, involved severing white matter tracks to and fro from the prefrontal cortex . There were many modifications of the basic procedure. The American neurologist Walter Freeman popularized the transorbital frontal lobotomy in which electroconvulsive therapy was used for anesthesia and then an ice-prick resembling instrument called the leucotome was inserted into the orbital roof by lifting the upper eyelid 2, . A hammer or a mallet was then used to drive the leucotome through the thin layer of orbital bone into the patient’s brain. The leucotome was then swept across from side to side severing the connections of the prefrontal cortex.
{"title":"Neurology pictorial: Scars of psychosurgery: frontal lobotomy","authors":"J. Torgovnick, N. Sethi, E. Arsura, P. Sethi","doi":"10.5580/2533","DOIUrl":"https://doi.org/10.5580/2533","url":null,"abstract":"Frontal lobotomy, a form of psychosurgery popular in the 1930s to 1950s, involved severing white matter tracks to and fro from the prefrontal cortex . There were many modifications of the basic procedure. The American neurologist Walter Freeman popularized the transorbital frontal lobotomy in which electroconvulsive therapy was used for anesthesia and then an ice-prick resembling instrument called the leucotome was inserted into the orbital roof by lifting the upper eyelid 2, . A hammer or a mallet was then used to drive the leucotome through the thin layer of orbital bone into the patient’s brain. The leucotome was then swept across from side to side severing the connections of the prefrontal cortex.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132173610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Wilson disease is rarely associated with peripheral neuropathy. Case Report: We report on a 50 y old male with an unusual manifestation of Wilson disease. The patient presented with burning feet syndrome. Nerve conduction studies revealed a mild axonal and myelin damage. In genetic testing, a homozygous point mutation (c.3207C>A) on the ATP7B gene was found. Conclusions: Physicians should be aware that patients suffering from Wilson disease may present with a broad spectre of symptoms, including signs of polyneuropathy.
{"title":"An unusual manifestation of Wilson disease presenting with burning feet syndrome","authors":"J. Rollnik, I. Rost, C. Marschall, P. Wetzel","doi":"10.5580/3e7","DOIUrl":"https://doi.org/10.5580/3e7","url":null,"abstract":"Background: Wilson disease is rarely associated with peripheral neuropathy. Case Report: We report on a 50 y old male with an unusual manifestation of Wilson disease. The patient presented with burning feet syndrome. Nerve conduction studies revealed a mild axonal and myelin damage. In genetic testing, a homozygous point mutation (c.3207C>A) on the ATP7B gene was found. Conclusions: Physicians should be aware that patients suffering from Wilson disease may present with a broad spectre of symptoms, including signs of polyneuropathy.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132830866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Multiple myeloma is a hematopoietic disorder and multicentric disease, with the most common localization being the spine. A 53-year-old male presented with progressive paraplegia, superficial and deep sensory disturbance below the level of T2. Spinal magnetic resonance image showed an epidural mass compressing the spinal cord at the level of T1 with intact bone structure. The patient underwent surgical posterior spinal decompression. Microscopic examination and immuno-histochemical studies confirmed the diagnosis of multiple myeloma of kappa subtype. The patient was subsequently started on steroids and chemotherapy for myeloma.Extra osseous epidural tumors causing compression myelopathy without evidence of destruction or collapse of vertebral bodies are relatively rare; to our knowledge very few cases exist in the literature.
{"title":"Thoracic Cord Compression by epidural Multiple Myeloma: A Rare Presentation of Multiple Myeloma","authors":"F. Aziz, S. Doddi, Shanker Ghimire","doi":"10.5580/25d","DOIUrl":"https://doi.org/10.5580/25d","url":null,"abstract":"Multiple myeloma is a hematopoietic disorder and multicentric disease, with the most common localization being the spine. A 53-year-old male presented with progressive paraplegia, superficial and deep sensory disturbance below the level of T2. Spinal magnetic resonance image showed an epidural mass compressing the spinal cord at the level of T1 with intact bone structure. The patient underwent surgical posterior spinal decompression. Microscopic examination and immuno-histochemical studies confirmed the diagnosis of multiple myeloma of kappa subtype. The patient was subsequently started on steroids and chemotherapy for myeloma.Extra osseous epidural tumors causing compression myelopathy without evidence of destruction or collapse of vertebral bodies are relatively rare; to our knowledge very few cases exist in the literature.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114341189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We found a high prevalence of dogs among animals kept at home in some villages at the former Transkei where the prevalence for cysticercosis is also high. From our personal experience on the field of epilepsy and neurocysticercosis (NCC) and its radiological signs on CT scan of the brain we were able to identified some nodular and hyperdense lesion on the cerebral hemisphere which not resemble NCC at any stage but we could not confirm any other parasitic zoonoses of the brain because our lack of resources for a proper laboratory diagnoses. Because we have a strong suspicion about Toxocariasis among our patients we reviewed the available medical literature to conclude that we have more suspicion about the presence of Toxocariasis in our population as another challenger to consider.
{"title":"Parasitic Zoonoses Of The Brain: Another Challenger?","authors":"H. Foyaca-Sibat, L. Ibañez-Valdés, Morris Jc","doi":"10.5580/b27","DOIUrl":"https://doi.org/10.5580/b27","url":null,"abstract":"We found a high prevalence of dogs among animals kept at home in some villages at the former Transkei where the prevalence for cysticercosis is also high. From our personal experience on the field of epilepsy and neurocysticercosis (NCC) and its radiological signs on CT scan of the brain we were able to identified some nodular and hyperdense lesion on the cerebral hemisphere which not resemble NCC at any stage but we could not confirm any other parasitic zoonoses of the brain because our lack of resources for a proper laboratory diagnoses. Because we have a strong suspicion about Toxocariasis among our patients we reviewed the available medical literature to conclude that we have more suspicion about the presence of Toxocariasis in our population as another challenger to consider.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130225201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The New York Times published a plot description of the movie “In the Matter of Karen Ann Quinlan.” It can be read: “After a serious accident, New Jersey woman Karen Ann Quinlan lapses into an irreversible coma. Only a complicated and expensive life-support system forestalls Karen's inevitable death; otherwise, she is brain dead and her prognosis is hopeless.” [3] Hence, in this portrayal terms like “irreversible coma”, “brain dead”, “prognosis is hopeless”, are misunderstood.
{"title":"Portrayal Of Persistent Vegetative States In The Media","authors":"Sh Foyaca","doi":"10.5580/1c8c","DOIUrl":"https://doi.org/10.5580/1c8c","url":null,"abstract":"The New York Times published a plot description of the movie “In the Matter of Karen Ann Quinlan.” It can be read: “After a serious accident, New Jersey woman Karen Ann Quinlan lapses into an irreversible coma. Only a complicated and expensive life-support system forestalls Karen's inevitable death; otherwise, she is brain dead and her prognosis is hopeless.” [3] Hence, in this portrayal terms like “irreversible coma”, “brain dead”, “prognosis is hopeless”, are misunderstood.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128017675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guillain Barre Syndrome is an acute demyelinating disorder of spinal roots and peripheralnerves occasionally the cranial nerves due to an immune-mediated disturbance involving the peripheral myelin sheath. It is characterized clinically by acute ascending type of motor weakness of limbs with hypoor a reflexia with preserved sensation and autonomic nervous system. However, other GBS variants like pure acute panautonomia3, Miller Fisher syndrome4, polyneuritis cranialis, pharyngeal-cervical-brachial variant5, facial diplegia with hyper reflexes6 have also been reported. Patient presented with sub acute , progressive, weakness of all four limbsassociated with hyper reflexia and loss of pain and temperature, with electrophysiological features suggestive of severe demyelinating neuropathy motor as well as sensory component and responding to IVIG.
{"title":"Yet Another Variant Of Gbs With Hyperrelexia And Loss Of Pain","authors":"H. Bhatia, M. Velumurugan, Ali al Bashpshe","doi":"10.5580/1054","DOIUrl":"https://doi.org/10.5580/1054","url":null,"abstract":"Guillain Barre Syndrome is an acute demyelinating disorder of spinal roots and peripheralnerves occasionally the cranial nerves due to an immune-mediated disturbance involving the peripheral myelin sheath. It is characterized clinically by acute ascending type of motor weakness of limbs with hypoor a reflexia with preserved sensation and autonomic nervous system. However, other GBS variants like pure acute panautonomia3, Miller Fisher syndrome4, polyneuritis cranialis, pharyngeal-cervical-brachial variant5, facial diplegia with hyper reflexes6 have also been reported. Patient presented with sub acute , progressive, weakness of all four limbsassociated with hyper reflexia and loss of pain and temperature, with electrophysiological features suggestive of severe demyelinating neuropathy motor as well as sensory component and responding to IVIG.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"179 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116167203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cerebral venous sinus thrombosis (CVST) is a rare and potentially fatal condition. A 23-year-old man was admitted to the emergency department of Maresal Cakmak Military Hospital, Erzurum two times in one week for epileptiform seizures. As noncontrast head computed tomography (CT) scan was normal, he was first diagnosed with epilepsy. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) showed the thrombus in the right transverse sinus, right straight sinus, and superior sagittal sinus. CVST should be considered for the differential diagnosis of patients who were admitted to the emergency department with epilepsy or epileptiform seizures and both MRI and MRV should be used for the diagnosis.
{"title":"Cerebral venous sinus thrombosis presenting to the emergency department with recurrent epileptiform seizure; Case Report","authors":"Y. Çevik, H. Dolu, M. Onay, C. Kavalci","doi":"10.5580/c95","DOIUrl":"https://doi.org/10.5580/c95","url":null,"abstract":"Cerebral venous sinus thrombosis (CVST) is a rare and potentially fatal condition. A 23-year-old man was admitted to the emergency department of Maresal Cakmak Military Hospital, Erzurum two times in one week for epileptiform seizures. As noncontrast head computed tomography (CT) scan was normal, he was first diagnosed with epilepsy. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) showed the thrombus in the right transverse sinus, right straight sinus, and superior sagittal sinus. CVST should be considered for the differential diagnosis of patients who were admitted to the emergency department with epilepsy or epileptiform seizures and both MRI and MRV should be used for the diagnosis.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116780958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cockayne Syndrome (CS) is a multisystem photosensitive genetic disorder due to a defect in DNA repair. The hallmarks of Cockayne syndrome are postnatal growth failure and progressive neurological dysfunction. We describe three patients; A 23 year old female with psychomotor and growth retardation, difficulty with ambulation and impaired hearing and her 2 cousins; a 17 year old male and his 13 year old brother both referred with similar problems. The mothers of the patients are sisters and their fathers are brothers.
{"title":"Cockayne Syndrome. Report of three cases in a South African family of Indian origin.","authors":"Y. Yacoob, Bill Pla, Patel","doi":"10.5580/17e2","DOIUrl":"https://doi.org/10.5580/17e2","url":null,"abstract":"Cockayne Syndrome (CS) is a multisystem photosensitive genetic disorder due to a defect in DNA repair. The hallmarks of Cockayne syndrome are postnatal growth failure and progressive neurological dysfunction. We describe three patients; A 23 year old female with psychomotor and growth retardation, difficulty with ambulation and impaired hearing and her 2 cousins; a 17 year old male and his 13 year old brother both referred with similar problems. The mothers of the patients are sisters and their fathers are brothers.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114448422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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