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| __NOTOC__ | | __NOTOC__ |
| {{SI}} | | |
| | {{Ophthalmoparesis}} |
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| | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
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| {{CMG}} | | {{CMG}} |
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| ==Overview==
| | {{SK}} Ophthalmoplegia |
| '''Ophthalmoparesis''' is a physical finding in certain [[neurology|neurologic]] illnesses. It refers to paralysis of the [[extraocular muscles]] which are responsible for [[eye movements]]. It can refer to complete paralysis of the eyes, in which case it is synonymous with '''ophthalmoplegia'''. More usually, it refers to a partial paralysis, in contrast to the complete paralysis denoted by ophthalmoplegia.
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| ==Classification== | | ==[[Ophthalmoparesis overview|Overview]]== |
| Ophthalmoparesis can involve any or all of the extraocular muscles, which include the [[superior rectus muscle|superior recti]], [[inferior rectus muscle|inferior recti]], [[medial rectus muscle|medial recti]], [[lateral rectus muscle|lateral recti]], [[inferior oblique muscle|inferior oblique]] and [[superior oblique muscle]]s.
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| It can also be classified by the directions of affected movements, e.g. "vertical ophthalmoparesis".
| | ==[[Ophthalmoparesis historical perspective|Historical Perspective]]== |
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| Types of ophthalmoplegia are:
| | ==[[Ophthalmoparesis classification|Classification]]== |
| *[[Progressive external ophthalmoplegia]]
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| *[[Supranuclear ophthalmoplegia]]
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| ==Causes== | |
| Ophthalmoparesis can result from disorders of various parts of the eye and nervous system:
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| * The [[orbit (anatomy)|orbit]] of the eye, including mechanical restrictions of eye movement, as in [[Graves' disease|Graves disease]].
| | ==[[Ophthalmoparesis pathophysiology|Pathophysiology]]== |
| * The [[muscle]], as in [[progressive external ophthalmoplegia]] or [[Kearns-Sayre syndrome]]
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| * The [[neuromuscular junction]], as in [[myasthenia gravis]].
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| * The [[cranial nerves|cranial nerve]]s or their brainstem nuclei of the [[oculomotor nerve|oculomotor]], [[trochlear nerve|trochlear]], and [[abducens nerve|abducens]].
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| * White matter tracts in the brainstem, as in [[internuclear ophthalmoplegia]], an occasional finding in [[multiple sclerosis]].
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| * Injury to supranuclear structures, as in [[progressive supranuclear palsy]].
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| * Very rarely, disorders of higher brain structures, including the [[parietal lobe]]s of the cerebral cortex.
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| [[Thiamine]] deficiency can cause '''ophthalmoparesis''' in susceptible persons; this is part of the syndrome called [[Wernicke's encephalopathy|Wernicke encephalopathy]]. The causal pathway by which this occurs is unknown. Intoxication with certain substances, such as [[phenytoin]], can also cause ophthalmoparesis. | | ==[[Ophthalmoparesis causes|Causes]]== |
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| ===Common Causes=== | | ==[[Ophthalmoparesis differential diagnosis|Differentiating Ophthalmoparesis from other Diseases]]== |
| *List the most common causes here.
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| ===Causes by Organ System===
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| {|style="width:82%; height:100px" border="1"
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| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
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| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Carotid artery dissection]], [[Carotid-cavernous fistula]], [[Aortic coarctation|Coarctation of aorta]], [[Hypertension]], [[Ischemia|Ischemia ]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Chemical/Poisoning'''
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| |bgcolor="Beige"| [[Amnesic shellfish poisoning]], [[Aralytic shellfish poisoning|Aralytic shellfish poisoning ]], [[Venomous snake|Atractaspididae (african mole viper)]], [[Carbamate|Carbamates]], [[Marine toxins|Ciguatera poisoning]], [[Snakebites (Patient information)|Cobra poisoning ]], [[Venomous snake|Colubridae (boomslang, twig snake)]], Crotoxin [[Venomous snake|(Rattlesnake)]], [[Venomous snake|Elapidae]], [[Eurotoxic shellfish poisoning]], [[Kraits]], [[Mamba]] snake, [[Notexin (tiger snake)]], [[Organophosphate|Organophosphates]], [[Scombroid food poisoning|Scombroid poisoning]], [[Taipoxin]] (taipan), [[Viperidae]] -[[bungarotoxin]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Dental'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Dermatologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Drug Side Effect'''
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| |bgcolor="Beige"| [[Aminoglycoside|Aminoglycoside ]], [[Atorvastatin]], [[Beta blockers]], [[Carbamate|Carbamates]], [[Carbamazepine]], [[Penicillamine|D-penicillamine]], [[Quinolone|Fluoroquinolone ]], [[Fluvastatin]], [[Glucocorticoids]], [[Gold]], [[Lithium]], [[Lovastatin]], [[Organophosphate|Organophosphates]], [[Phenytoin ]], [[Pitavastatin]], [[Pravastatin]], [[Pregabalin]], [[Simvastatin]], [[Vincristine]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Ear Nose Throat'''
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| |bgcolor="Beige"| [[Acute bacterial rhinosinusitis]], [[Arias oculootoradial syndrome]], [[Gradenigo-lannois syndrome]], [[Nasopharyngeal carcinoma]], [[Neck masses]], [[Otitis media]], [[Wildervanck syndrome]]
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| |-bgcolor="LightSteelBlue"
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| | '''Endocrine'''
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| |bgcolor="Beige"| [[Diabetes mellitus]], [[Graves' disease]], [[Growth hormone secreting pituitary adenoma]]
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| |-bgcolor="LightSteelBlue"
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| | '''Environmental'''
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| |bgcolor="Beige"| [[Alcoholism]], [[Amnesic shellfish poisoning]], [[Aralytic shellfish poisoning|Aralytic shellfish poisoning ]], [[Atractaspididae (african mole viper)]], [[Botulism]], [[Carbamate|Carbamates]], [[Marine toxins|Ciguatera poisoning]], [[Snakebites (Patient information)|Cobra poisoning ]], [[Colubridae (boomslang, twig snake)]], [[Crotoxin (brazilian rattle snake)]], [[Elapidae]], [[Eurotoxic shellfish poisoning]], [[Gold]], [[Kraits]], [[Mamba snake]], [[Notexin (tiger snake)]], [[Organophosphate|Organophosphates]], [[Scombroid food poisoning|Scombroid poisoning]], [[Taipoxin (taipan)]], [[Thiamine deficiency]], [[Tick paralysis]], [[Toscana virus]], [[Viperidae beta-bungarotoxin (krait)]], [[Wernicke-korsakoff syndrome]]
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| |-bgcolor="LightSteelBlue"
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| | '''Gastroenterologic'''
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| |bgcolor="Beige"| [[Inflammatory bowel disease]], [[Myoneurogastrointestinal encephalopathy syndrome]], [[Whipple's disease]],
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| |-bgcolor="LightSteelBlue"
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| | '''Genetic'''
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| |bgcolor="Beige"| [[Aarskog syndrome]], [[Agenesis of extraocular muscles]], [[Angelman-like syndrome]], [[Athabaskan brain stem dysgenesis]], [[Autosomal-dominant progressive external opthalmoplegia (adPEO)]], [[Central core myopathy]], [[Centronuclear myopathy]], [[Christianson type x-linked mental retardation]], [[Congenital fiber-type disproportion myopathy]], [[Congenital fibrosis of extraocular muscles(FEOM)]], [[Diabetes mellitus]], [[Duane ocular retraction syndrome]], [[Ehlers danlos syndrome]], [[Familial horizontal gaze palsy with progressive scoliosis]], [[Fatty acid hydroxylase-associated neurodegeneration]], [[Friedreich ataxia]], [[Infantile-onset spinocerebellar ataxia]], [[Kearns-sayre syndrome]], [[Kufor-rakeb syndrome]], [[Lambert-eaton myasthenic syndrome]], [[Levic-stefanovic-nikolic syndrome ]], [[Limb-girdle muscular dystrophy ]], [[MELAS syndrome]], [[Niemann-pick disease]], [[Oculopharyngeal muscular dystrophy]], [[Polycystic kidney disease ]], [[Vertebrobasilar insufficiency]]
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| |-bgcolor="LightSteelBlue"
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| | '''Hematologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Iatrogenic'''
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| |bgcolor="Beige"| [[Amnesic shellfish poisoning]], [[Aralytic shellfish poisoning|Aralytic shellfish poisoning ]], [[Atractaspididae (african mole viper)]], [[Brain injury]], [[Marine toxins|Ciguatera poisoning]], [[Snakebites (Patient information)|Cobra poisoning ]], [[Colubridae (boomslang, twig snake)]], [[Crotoxin (brazilian rattle snake)]], [[Eurotoxic shellfish poisoning]], [[Eye Packing]], [[Gold]], [[Guillain-barre syndrome ]], [[Kraits]], [[Lumbar epidural anesthesia ]], [[Magnesium sulfate]], [[Mamba snake]], [[Notexin (tiger snake)]], [[Raised intracranial pressure]], [[Scombroid food poisoning|Scombroid poisoning]], [[Taipoxin (taipan)]], [[Tick paralysis]], [[Viperidae beta-bungarotoxin (krait)]]
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| |-bgcolor="LightSteelBlue"
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| | '''Infectious Disease'''
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| |bgcolor="Beige"| [[Acute bacterial rhinosinusitis]], [[Acute disseminated encephalomyelitis]], [[Aspergillus sp]], [[Bacterial conjunctivitis]], [[Blepharitis]], [[Botulism]], [[Brain abscess]], [[Episcleritis]], [[Fungal conjunctivitis]], [[Infection ]], [[Inflamed pterygium]], [[Optic neuritis]], [[Otitis media]], [[Periorbital cellulitis]], [[Preseptal cellulitis]], [[Quaternary syphilis]], [[Rabies]], [[Rhino-orbital-cerebral mucormycosis ]], [[Scleritis]], [[Toscana virus]], [[Tuberculosis]]
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| |-bgcolor="LightSteelBlue"
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| | '''Musculoskeletal/Orthopedic'''
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| |bgcolor="Beige"| [[Aarskog syndrome]], [[Angelman-like syndrome]], [[Ataxia-oculomotor apraxia type 1]], [[Central core myopathy]], [[Central nervous system angiitis]], [[Centronuclear myopathy]], [[Congenital fiber-type disproportion myopathy]], [[Duane ocular retraction syndrome]], [[Ehlers danlos syndrome]], [[Kufor-rakeb syndrome]], [[Lambert-eaton myasthenic syndrome]], [[Limb-girdle muscular dystrophy ]], [[Multicore myopathy]], [[Myasthenia gravis]], [[Myoneurogastrointestinal encephalopathy syndrome]], [[Myotubular myopathy ]], [[Oculopharyngeal muscular dystrophy]], [[Rheumatoid arthritis]]
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| |-bgcolor="LightSteelBlue"
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| | '''Neurologic'''
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| |bgcolor="Beige"| [[Acute disseminated encephalomyelitis]], [[Angelman-like syndrome]], [[Arachnoid cyst]], [[Ataxia-oculomotor apraxia type 1]], [[Ataxia-oculomotor apraxia type 2]], [[Athabaskan brain stem dysgenesis]], [[Autosomal-dominant progressive external opthalmoplegia (adPEO)]], [[Basilar artery migraine]], [[Benedikt syndrome]], [[Berry aneurysm]], [[Bickerstaff's brain stem encephalitis]], [[Brain abscess]], [[Brain injury]], [[Brain tumour]], [[Cavernous sinus dural arteriovenous fistula ]], [[Cavernous sinus thrombosis]], [[Central core myopathy]], [[Central nervous system angiitis]], [[Centronuclear myopathy]], [[Christianson type x-linked mental retardation]], [[Claude syndrome]], [[Clinically isolated syndrome (CIS)]], [[Dermoid cyst]], [[Foville's syndrome]], [[Friedreich ataxia]], [[Graves' disease]], [[Growth hormone secreting pituitary adenoma]], [[Guillain-barre syndrome ]], [[Horner's syndrome]], [[Infantile-onset spinocerebellar ataxia]], [[Intracranial aneurysm]], [[Intracranial space-occupying lesion]], [[Ischemia|Ischemia ]], [[Kearns-sayre syndrome]], [[Kufor-rakeb syndrome]], [[Lambert-eaton myasthenic syndrome]], [[Lateral medullary syndrome]], [[Levic-stefanovic-nikolic syndrome ]], [[Miller fisher syndrome]], [[Multicore myopathy]], [[Multiple sclerosis]], [[Myasthenia gravis]], [[Myoneurogastrointestinal encephalopathy syndrome]], [[Myotubular myopathy ]], [[Neuromyelitis optica]], [[Neurosarcoidosis]], [[Niemann-pick disease]], [[Nothnagel syndrome]], [[Olivopontocerebellar syndrome]], [[Pancoast tumour]], [[Paraneoplastic encephalomyelitis]], [[Parinaud's syndrome ]], [[Pituitary apoplexy]], [[Progressive supranuclear palsy]], [[Pseudoophthalmoplegia]], [[Pseudotumor cerebri]], [[Quaternary syphilis]], [[Raised intracranial pressure]], [[Raymond cestan syndrome]], [[Rhino-orbital-cerebral mucormycosis ]], [[Rollet syndrome ]], [[Sturge-Weber syndrome]], [[Subarchnoid hemorrhage]], [[Subdural hematoma]], [[Syringobulbia]], [[Tick paralysis]], [[Tolosa-hunt syndrome]], [[Transverse myelitis]], [[Vertebrobasilar insufficiency]], [[Weber syndrome]], [[Wildervanck syndrome]]
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| |-bgcolor="LightSteelBlue"
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| | '''Nutritional/Metabolic'''
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| |bgcolor="Beige"| [[Fatty acid hydroxylase-associated neurodegeneration]], [[Hypermagnesemia]], [[Hypocalcemia ]], [[Magnesium sulfate]], [[Niemann-pick disease]], [[Thiamine deficiency]], [[Uremia]], [[Wernicke-korsakoff syndrome]]
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| |-bgcolor="LightSteelBlue"
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| | '''Obstetric/Gynecologic'''
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| |bgcolor="Beige"|[[Postnatal trauma]]
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| |-bgcolor="LightSteelBlue"
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| | '''Oncologic'''
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| |bgcolor="Beige"| [[Arachnoid cyst]], [[Brain tumour]], [[Carcinoma lung]], [[Dermoid cyst]], [[Intracranial space-occupying lesion]], [[Melanoma-associated retinopathy]], [[Metastasis]], [[Nasopharyngeal carcinoma]], [[Neck masses]], [[Orbital tumors ]], [[Paraneoplastic encephalomyelitis]], [[Paraneoplastic optic neuritis]]
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| |-bgcolor="LightSteelBlue"
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| | '''Ophthalmologic'''
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| |bgcolor="Beige"| [[Agenesis of extraocular muscles]], [[Arias oculootoradial syndrome]], [[Ataxia-oculomotor apraxia type 1]], [[Ataxia-oculomotor apraxia type 2]], [[Autosomal-dominant progressive external opthalmoplegia (adPEO)]], [[Bacterial conjunctivitis]], [[Blepharitis]], [[Clinically isolated syndrome (CIS)]], [[Congenital fiber-type disproportion myopathy]], [[Congenital fibrosis of extraocular muscles(FEOM)]], [[Corneal erosion]], [[Corneal ulcer]], [[Duane ocular retraction syndrome]], [[Ehlers danlos syndrome]], [[Episcleritis]], [[Exophthalmos]], [[Eye Packing]], [[Familial horizontal gaze palsy with progressive scoliosis]], [[Fungal conjunctivitis]], [[Inflamed pterygium]], [[Kearns-sayre syndrome]], [[Levic-stefanovic-nikolic syndrome ]], [[Melanoma-associated retinopathy]], [[Neuromyelitis optica]], [[Oculopharyngeal muscular dystrophy]], [[Optic neuritis]], [[Orbital fracture with nerve entrapment]], [[Orbital pseudotumor]], [[Orbital tumors ]], [[Paraneoplastic optic neuritis]], [[Periorbital cellulitis]], [[Preseptal cellulitis]], [[Progressive supranuclear palsy]], [[Pseudoophthalmoplegia]], [[Raymond cestan syndrome]], [[Rhino-orbital-cerebral mucormycosis ]], [[Rollet syndrome ]], [[Scleritis]], [[Sjögren syndrome]], [[Superior orbital fissure syndrome]], [[Tolosa-hunt syndrome]], [[Trachoma]], [[Wildervanck syndrome]]
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| |-bgcolor="LightSteelBlue"
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| | '''Overdose/Toxicity'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Psychiatric'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Pulmonary'''
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| |bgcolor="Beige"| [[Carcinoma lung]], [[Pancoast tumour]]
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| |-bgcolor="LightSteelBlue"
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| | '''Renal/Electrolyte'''
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| |bgcolor="Beige"| [[Polycystic kidney disease ]], [[Uremia]]
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| |-bgcolor="LightSteelBlue"
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| | '''Rheumatology/Immunology/Allergy'''
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| |bgcolor="Beige"| [[Bickerstaff's brain stem encephalitis]], [[Inflammatory bowel disease]], [[Microscopic polyangiitis]], [[Neurosarcoidosis]], [[Optic neuritis]], [[Rheumatoid arthritis]], [[Scleroderma]], [[Sjögren syndrome]], [[Systemic lupus erythematosus]], [[Systemic sclerosis ]], [[Wegener's syndrome]]
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| |-bgcolor="LightSteelBlue"
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| | '''Sexual'''
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| |bgcolor="Beige"| [[Aarskog syndrome]]
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| |-bgcolor="LightSteelBlue"
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| | '''Trauma'''
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| |bgcolor="Beige"| [[Brain injury]], [[Orbital fracture with nerve entrapment]], [[Postnatal trauma]]
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| |-bgcolor="LightSteelBlue"
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| | '''Urologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Miscellaneous'''
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| |bgcolor="Beige"| No underlying causes
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| |}
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| ===Causes in Alphabetical Order=== | | ==[[Ophthalmoparesis epidemiology and demographics|Epidemiology and Demographics]]== |
| {{col-begin|width=84%}}
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| {{col-break|width=33%}}
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| *[[Disease]] A
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| *[[Disease]] B
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| *[[Disease]] C
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| *[[Disease]] ...
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| {{col-break|width=33%}}
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| *[[Disease]] P
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| *[[Disease]] Q
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| *[[Disease]] R
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| *[[Disease]] ...
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| {{col-break|width=33%}}
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| *[[Disease]] X
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| *[[Disease]] Y
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| *[[Disease]] Z
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| {{col-end}}
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| ==Differentiating Opthalmoparesis from other Conditions== | | ==[[Ophthalmoparesis risk factors|Risk Factors]]== |
| *Acute cranial polyneuropathy
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| *[[Adie syndrome]]
| | ==[[Ophthalmoparesis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| *Bilateral third nerve involvement
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| *[[Botulism]]
| | ==Diagnosis== |
| *Brainstem [[stroke]]
| | [[Ophthalmoparesis history and symptoms| History and Symptoms]] | [[Ophthalmoparesis physical examination | Physical Examination]] | [[Ophthalmoparesis laboratory findings|Laboratory Findings]] | [[Ophthalmoparesis CT|CT]] | [[Ophthalmoparesis other imaging findings|Other Imaging Findings]] | [[Ophthalmoparesis other diagnostic studies|Other Diagnostic Studies]] |
| *[[Diptheria]]
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| *[[Drugs]]
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| *Iris injury
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| *[[Meningitis]]
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| *[[Myasthenia gravis]]
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| *[[Tetanus]]
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| *Midbrain lesion
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| *[[Vasculitis]]
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| ==Treatment== | | ==Treatment== |
| Treatment depend on the underlying condition.
| | [[Ophthalmoparesis medical therapy|Medical Therapy]] | [[Ophthalmoparesis surgery|Surgery]] | [[Ophthalmoparesis primary prevention|Primary Prevention]] | [[Ophthalmoparesis secondary prevention|Secondary Prevention]] | [[Ophthalmoparesis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Ophthalmoparesis future or investigational therapies|Future or Investigational Therapies]] |
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| | ==Case Studies== |
| | [[Ophthalmoparesis case study one|Case#1]] |
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| ==Related Chapters== | | ==Related Chapters== |
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| {{Eye pathology}} | | {{Eye pathology}} |
| | {{WH}} |
| | {{WikiDoc Sources}} |
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| [[Category:Neurology]] | | [[Category:Neurology]] |
| [[Category:Medical signs]]
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| [[Category:Overview complete]] | | [[Category:Overview complete]] |
| [[Category:Primary care]]
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| [[sv:Internukleär oftalmoplegi]]
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| {{WH}}
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| {{WikiDoc Sources}}
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