Selective and sequential therapy of oculomotor and palpebral sequelae resulting from biopsy of dorsal midbrain sarcoidosis

Détails

ID Serval
serval:BIB_73E04151F677
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Selective and sequential therapy of oculomotor and palpebral sequelae resulting from biopsy of dorsal midbrain sarcoidosis
Périodique
Klinische Monatsblatter fur Augenheilkunde
Auteur(s)
Klainguti  G., Spahn  B., Borruat  F. X.
ISSN
0023-2165 (Print)
Statut éditorial
Publié
Date de publication
05/2004
Volume
221
Numéro
5
Pages
404-7
Notes
Case Reports
Journal Article --- Old month value: May
Résumé
BACKGROUND: Biopsy of a dorsal mesencephalon lesion often leads to neuro-ophthalmological complications, namely dorsal mesencephalic syndrome, skew deviation, IV (th) palsy, or Horner's syndrome. HISTORY AND SIGNS: A 26-year-old man underwent a biopsy of the quadrigeminal plate for a lesion which revealed to be neurosarcoidosis. Post-operative complications included a left homonymous hemianopia, a left III (rd) nucleus palsy, a bilateral IV (th) palsy and a bilateral internuclear ophthalmoplegia. Palpebral fissures were narrowed to 2 mm on both sides. In primary gaze there was 24 degrees of exotropia, 17 degrees of right hypertropia and 30 degrees of exyclorotation. THERAPY AND OUTCOME: After 24 months of stable evolution, three oculomotor surgical procedures were performed including: surgery on both horizontal muscles of the left eye; shortening of both superior oblique muscles; resection of the right lateral rectus muscle, and posterior fixation of an inferior rectus muscle. Bilateral brow suspension on the frontal muscle of both superior eyelids was then performed. Evolution was favorable with a binocular single field of vision measuring 17 degrees horizontally and 20 degrees vertically centered on the primary gaze. Palpebral fissures measured 7 to 8 mm in primary gaze. CONCLUSIONS: The neuro-ophthalmological sequelae which followed the biopsy of a neurosarcoidosis lesion of the quadrigeminal plate were so severe that this patient was completely handicapped. A four-step surgery correcting the horizontal, torsional, vertical components, then the bilateral ptosis allowed the patient to recover both a satisfying function and esthetical aspect.
Mots-clé
Adult Biopsy/*adverse effects Blepharoptosis/diagnosis/*surgery Brain Diseases/*pathology Corpora Quadrigemina/pathology Exotropia/diagnosis/surgery Follow-Up Studies Humans Magnetic Resonance Imaging Male Mesencephalon/*pathology Occipital Lobe/injuries/pathology Oculomotor Muscles/surgery Oculomotor Nerve Diseases/diagnosis/*surgery Postoperative Complications/diagnosis/*surgery Reoperation Sarcoidosis/*pathology Strabismus/diagnosis/surgery Trochlear Nerve Diseases/diagnosis/*surgery
Pubmed
Web of science
Création de la notice
28/01/2008 13:37
Dernière modification de la notice
03/03/2018 18:20
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