Ophthalmoparesis: Difference between revisions
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Ophthalmoparesis can result from disorders of various parts of the eye and nervous system: | Ophthalmoparesis can result from disorders of various parts of the eye and nervous system: | ||
* The [[orbit (anatomy)|orbit]] of the eye, including mechanical restrictions of eye movement, as in [[Graves disease]]. | * The [[orbit (anatomy)|orbit]] of the eye, including mechanical restrictions of eye movement, as in [[Graves' disease|Graves disease]]. | ||
* The [[muscle]], as in [[progressive external ophthalmoplegia]] or [[Kearns-Sayre syndrome]] | * The [[muscle]], as in [[progressive external ophthalmoplegia]] or [[Kearns-Sayre syndrome]] | ||
* The [[neuromuscular junction]], as in [[myasthenia gravis]]. | * The [[neuromuscular junction]], as in [[myasthenia gravis]]. | ||
* The [[cranial nerve]]s or their brainstem nuclei of the [[oculomotor nerve|oculomotor]], [[trochlear nerve|trochlear]], and [[abducens nerve|abducens]]. | * The [[cranial nerves|cranial nerve]]s or their brainstem nuclei of the [[oculomotor nerve|oculomotor]], [[trochlear nerve|trochlear]], and [[abducens nerve|abducens]]. | ||
* White matter tracts in the brainstem, as in [[internuclear ophthalmoplegia]], an occasional finding in [[multiple sclerosis]]. | * White matter tracts in the brainstem, as in [[internuclear ophthalmoplegia]], an occasional finding in [[multiple sclerosis]]. | ||
* Injury to supranuclear structures, as in [[progressive supranuclear palsy]]. | * Injury to supranuclear structures, as in [[progressive supranuclear palsy]]. | ||
* Very rarely, disorders of higher brain structures, including the [[parietal lobe]]s of the cerebral cortex. | * Very rarely, disorders of higher brain structures, including the [[parietal lobe]]s of the cerebral cortex. | ||
[[Thiamine]] deficiency can cause '''ophthalmoparesis''' in susceptible persons; this is part of the syndrome called [[Wernicke encephalopathy]]. The causal pathway by which this occurs is unknown. Intoxication with certain substances, such as [[phenytoin]], can also cause ophthalmoparesis. | [[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. | ||
===Common Causes=== | ===Common Causes=== | ||
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{|style="width:82%; height:100px" border="1" | {|style="width:82%; height:100px" border="1" | ||
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | ||
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | | |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Carotid artery dissection]], [[Carotid-cavernous fistula]], [[Aortic coarctation|Coarctation of aorta]], [[Hypertension]], [[Ischemia|Ischemia ]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Chemical/Poisoning''' | | '''Chemical/Poisoning''' | ||
|bgcolor="Beige"| | |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]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Drug Side Effect''' | | '''Drug Side Effect''' | ||
|bgcolor="Beige"| | |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]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Ear Nose Throat''' | | '''Ear Nose Throat''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Acute bacterial rhinosinusitis]], [[Arias oculootoradial syndrome]], [[Gradenigo-lannois syndrome]], [[Nasopharyngeal carcinoma]], [[Neck masses]], [[Otitis media]], [[Wildervanck syndrome]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Endocrine''' | | '''Endocrine''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Diabetes mellitus]], [[Graves' disease]], [[Growth hormone secreting pituitary adenoma]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Environmental''' | | '''Environmental''' | ||
|bgcolor="Beige"| | |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]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Gastroenterologic''' | | '''Gastroenterologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Inflammatory bowel disease]], [[Myoneurogastrointestinal encephalopathy syndrome]], [[Whipple's disease]], | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Genetic''' | | '''Genetic''' | ||
|bgcolor="Beige"| | |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]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Iatrogenic''' | | '''Iatrogenic''' | ||
|bgcolor="Beige"| | |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)]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Infectious Disease''' | | '''Infectious Disease''' | ||
|bgcolor="Beige"| | |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]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Musculoskeletal/Orthopedic''' | | '''Musculoskeletal/Orthopedic''' | ||
|bgcolor="Beige"| | |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]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Neurologic''' | | '''Neurologic''' | ||
|bgcolor="Beige"| | |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]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Nutritional/Metabolic''' | | '''Nutritional/Metabolic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Fatty acid hydroxylase-associated neurodegeneration]], [[Hypermagnesemia]], [[Hypocalcemia ]], [[Magnesium sulfate]], [[Niemann-pick disease]], [[Thiamine deficiency]], [[Uremia]], [[Wernicke-korsakoff syndrome]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Obstetric/Gynecologic''' | | '''Obstetric/Gynecologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"|[[Postnatal trauma]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Oncologic''' | | '''Oncologic''' | ||
|bgcolor="Beige"| | |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]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Ophthalmologic''' | | '''Ophthalmologic''' | ||
|bgcolor="Beige"| | |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]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Pulmonary''' | | '''Pulmonary''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Carcinoma lung]], [[Pancoast tumour]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Renal/Electrolyte''' | | '''Renal/Electrolyte''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Polycystic kidney disease ]], [[Uremia]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Rheumatology/Immunology/Allergy''' | | '''Rheumatology/Immunology/Allergy''' | ||
|bgcolor="Beige"| | |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]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Sexual''' | | '''Sexual''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Aarskog syndrome]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Trauma''' | | '''Trauma''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Brain injury]], [[Orbital fracture with nerve entrapment]], [[Postnatal trauma]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" |
Revision as of 16:50, 17 July 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Ophthalmoparesis is a physical finding in certain 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.
Classification
Ophthalmoparesis can involve any or all of the extraocular muscles, which include the superior recti, inferior recti, medial recti, lateral recti, inferior oblique and superior oblique muscles.
It can also be classified by the directions of affected movements, e.g. "vertical ophthalmoparesis".
Types of ophthalmoplegia are:
Causes
Ophthalmoparesis can result from disorders of various parts of the eye and nervous system:
- The orbit of the eye, including mechanical restrictions of eye movement, as in Graves disease.
- The muscle, as in progressive external ophthalmoplegia or Kearns-Sayre syndrome
- The neuromuscular junction, as in myasthenia gravis.
- The cranial nerves or their brainstem nuclei of the oculomotor, trochlear, and abducens.
- White matter tracts in the brainstem, as in internuclear ophthalmoplegia, an occasional finding in multiple sclerosis.
- Injury to supranuclear structures, as in progressive supranuclear palsy.
- Very rarely, disorders of higher brain structures, including the parietal lobes of the cerebral cortex.
Thiamine deficiency can cause ophthalmoparesis in susceptible persons; this is part of the syndrome called Wernicke encephalopathy. The causal pathway by which this occurs is unknown. Intoxication with certain substances, such as phenytoin, can also cause ophthalmoparesis.
Common Causes
- List the most common causes here.
Causes by Organ System
Causes in Alphabetical Order
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Differentiating Opthalmoparesis from other Conditions
- Acute cranial polyneuropathy
- Adie syndrome
- Bilateral third nerve involvement
- Botulism
- Brainstem stroke
- Diptheria
- Drugs
- Iris injury
- Meningitis
- Myasthenia gravis
- Tetanus
- Midbrain lesion
- Vasculitis
Treatment
Treatment depend on the underlying condition.
Related Chapters
sv:Internukleär oftalmoplegi
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