BACKGROUND Pituitary adenoma may present with neuro-ophthalmic manifestations and, typically, rapid tumor expansion is the result of apoplexy. Herein, we present the first case of an isolated sixth cranial nerve palsy as initial feature of a rapidly expanding ACTH positive silent tumor without apoplexy. CASE PRESENTATION A 44 year old female with a history of sarcoidosis presented with an iso...

BACKGROUND Seeing triple is a rare complaint, so anatomically unlikely that it is often considered a diagnostic symptom of hysteria. OBJECTIVE To evaluate the complaint of triple vision among a large group of neurological inpatients. DESIGN Personal case series during a 34-year period. SETTING Neurology and neurosurgery wards of the University of Southern California-Los Angeles County Med...

We studied three patients with spontaneous mesencephalic hemorrhages. All presented with some degree of impaired consciousness and abnormal ocular movements. One patient had a convergence-retraction nystagmus with a unilateral hemorrhage confined to the dorsal midbrain. Another patient showed left third nerve palsy due to a unilateral hemorrhage that involved ventral midbrain. The third patient...

We describe two cases of a unilateral fixed dilated pupil secondary to the ocular instillation of nebulised ipratropium bromide. In one patient there was no other neurological abnormality. The second patient was unconscious following a cardiac arrest. While a fixed dilated pupil is an alarming sign, if it is caused by ocular instillation of ipratropium bromide the condition will resolve, althou...

In this chapter we describe a variety of rare but clinically identifiable ocular motor syndromes, including ocular neuromyotonia, superior oblique myokymia, ocular motor synkinesis, third nerve palsy with cyclic spasms, and paroxysmal manifestations of multiple sclerosis. These syndromes share many characteristics. They result from neurogenic hyperactivity, causing episodic spasms of one or sev...

PURPOSE To report a case of Burkitt's lymphoma (BL) in an HIV-positive patient presenting as complete third nerve palsy. METHODS Interventional case report. A 34-year-old man presented with headache, left eye pain, diplopia, and complete ptosis of several hours' duration. Left eye examination disclosed complete third nerve palsy with pupillary involvement. Significant hepatomegalia was noted ...

A 65 year old black male presents with chronic right facial paralysis. After poor response to standard treatment, additional testing reveals seventh nerve palsy caused by parotid malignancy. I. Case History -Patient Demographics 65 year old black male presents for ophthalmic consultation requested by his otolaryngologist. -Chief Complaint Patient reports onset of right sided facial paralysis be...

Bell’s palsy is an idiopathic peripheral nerve palsy involving the facial nerve. It accounts for 60 to 75% of all cases of unilateral facial paralysis. The main mechanisms to induce BP remain unclear, but infection, ischemic condition and immunodeficiency may contribute to the development of Bell’s palsy. Accumulating evidence has shown several factors can trigger the reactivation of latent...