BACKGROUND/AIM Serum antibody against ganglioside GQ1b is reported to be closely associated with immune mediated ophthalmoplegia in the Fisher and Guillain-Barré syndromes. Its presence against glycolipids, in particular ganglioside GQ1b, was investigated in patients with ophthalmoplegia of unknown origin. METHODS 16 patients with ophthalmoplegia, the cause of which could not be confirmed fro...

Anuchit Poonyathalang1 Sangeeta Khanna2 R John Leigh2 1Department of Ophthalmology, Ramathibodi Hospital, Bangkok, Thailand; 2Neurology Service, Veterans Affairs Medical Center, Case Western Reserve University, Cleveland, Ohio, USA Abstract: Recent discoveries about the orbital tissues prompt a re-evaluation of the way that clinicians think about disorders affecting the extraocular muscles, the...

Recent discoveries about the orbital tissues prompt a re-evaluation of the way that clinicians think about disorders affecting the extraocular muscles, their nerves and motoneurons in the brainstem. The revolutionary discovery that the orbital layers of the extraocular muscles insert not onto the eyeball, but into fibromuscular pulleys that guide the orbital layers, provides explanations for th...

In 1949, amphetamine sulfate was replaced by propylhexedrine in the nasal decongestant agent Benzedrex because of psychosis, sudden death, and widespread abuse. Propylhexedrine is not without risks, and reported cases of psychosis, myocardial infarction, pulmonary vascular disease and pulmonary hypertension, and sudden death are well documented in the medical literature. We are reporting 2 case...

Occlusion of the rostral portion of the basilar artery can result in ischaemia of the midbrain and thalami, as well as of the temporal and occipital lobes. The so called "top of the basilar" syndrome manifests clinically as numerous combinations of abnormalities of alertness, sleep-wake cycle, and behaviour and oculomotor or pupillomotor functions. A 67 year old man presented with bilateral int...

BACKGROUND AND PURPOSE The mechanism of upbeat nystagmus is unknown and clinicoanatomical correlative studies in series of patients with upbeat nystagmus are limited. METHODS Fifteen patients with upbeat nystagmus received full neuro-ophthalmological evaluation by the senior author. Nystagmus was observed using video Frenzel goggles and recorded with video-oculography. Brain lesions were docu...

BACKGROUND AND PURPOSE Ocular manifestation is one of the frequent signs of an acute attack in multiple sclerosis (MS), although primary position upbeat nystagmus (PPUN) is rare. The purpose of this study is to determine the incidence of PPUN in MS and to determine the lesions that are responsible for this sign. METHODS The medical records of 120 MS patients with acute brain lesions were revi...

One of the most frequent disorders of the brainstem in multiple sclerosis (MS) is internuclear opthalmoplegia (INO). The aim of this study is to show how it is possible to monitor the course of MS grading INO on the basis of electro-oculographic findings. We selected 130 patients with a diagnosis of clinically defined multiple sclerosis (78 males and 52 females, mean age 43.5 years) from a popu...

A 73-year-old man suddenly presented with alternating exotropia, bilateral medial longitudinal fasciculus (MLF) syndrome, and impaired convergence. This symptom has been known as wall-eyed bilateral internuclear ophthalmoplegia (WEBINO syndrome). Diffusion-weighted images on magnetic resonance imaging showed a smalllocalized lesion in his pontine tegmentum. Based on he had some ischemic risk fa...

Case Report A 71-year-old female suffered a sudden onset of diplopia, dysarthria and paresthesias of the left hemiface and the upper left extremities. She had hypertension and dyslipidemia. Upon admission, the patient showed a right IV cranial nerve palsy, skew deviation, right internuclear ophthalmoplegia, dysarthria, left central facial palsy, left hemihipoestesia, right appendicular ataxia a...