The Experts below are selected from a list of 189 Experts worldwide ranked by ideXlab platform
Sung Mo Kang - One of the best experts on this subject based on the ideXlab platform.
-
Neurosyphilis Presenting Unilateral Oculomotor Nerve Palsy and Bilateral Pupil Involvement
Journal of Clinical & Experimental Ophthalmology, 2015Co-Authors: Hye In Park, Sung Mo KangAbstract:Of the symptomatic disorders associated with neurosyphilis, the earliest manifestation is syphilitic meningitis. Approximately 5% of patients with secondary syphilis develop associated meningitis. Headaches, meningismus, cranial nerve palsies (chiefly, in descending order of frequency, VII, VIII, VI, and II. Here, we report a case of neurosyphilis presenting as unilateral oculomotor nerve palsy with bilateral Pupil involvement (Argyll-Robertson Pupil). A 43-year-old male presented with diplopia in both eyes at a neurology clinic 2 weeks before. He had right paralytic blepharoptosis, and both Pupils were fixed and both Pupils were not observed direct and indirect reflex and anisocoric. We observed Argyll Robertson Pupil. He had 35 prisms of right exotropia, 2 prisms of right hypertropia at near and distance in the state of primary deviation and 60-prism right exotropia and 4- prism hypertropia in the state of secondary deviation. He had extraocular movement disorder in all gazes except abduction. We considered oculomotor nerve palsy associated with neurosyphilis based on the Argyll Robertson Pupil. His orbit MRI suggested right oculomotor neuritis due to the presence of diffuse thickening of the right oculomotor nerve with enhancement. Finally, he was diagnosed with syphilis as a result of CSF protein 96.0, VDRL 7.5, and FTA-ABS (+) and was administered penicillin (4,000,000 units) and oral steroid (50 mg). One week after, his intraocular pressure was in the normal range. Extraocular movement examination findings were favorable as a result of 20-prism right exotropia at near and distance in the state of primary deviation and 35-prism right exotropia in the state of secondary deviation. He had extraocular movement disorder only in upper gaze. A diagnosis of neurosyphilis should be considered in patients with serologic evidence of syphilis and one or more of the following cerebrospinal fluid abnormalities; mononuclear pleocytosis, elevated protein, increased immunoglobulin G, or the presence of oligoclonal bands.
-
Neurosyphilis Presenting Unilateral Oculomotor Nerve Palsy and Bilateral Pupil
2015Co-Authors: Involvementin Park, Sung Mo KangAbstract:Of the symptomatic disorders associated with neurosyphilis, the earliest manifestation is syphilitic meningitis. Approximately 5% of patients with secondary syphilis develop associated meningitis. Headaches, meningismus, cranial nerve palsies (chiefly, in descending order of frequency, VII, VIII, VI, and II. Here, we report a case of neurosyphilis presenting as unilateral oculomotor nerve palsy with bilateral Pupil involvement (Argyll-Robertson Pupil). A 43-year-old male presented with diplopia in both eyes at a neurology clinic 2 weeks before. He had right paralytic blepharoptosis, and both Pupils were fixed and both Pupils were not observed direct and indirect reflex and anisocoric. We observed Argyll Robertson Pupil. He had 35 prisms of right exotropia, 2 prisms of right hypertropia at near and distance in the state of primary deviation and 60-prism right exotropia and 4- prism hypertropia in the state of secondary deviation. He had extraocular movement disorder in all gazes except abduction. We considered oculomotor nerve palsy associated with neurosyphilis based on the Argyll Robertson Pupil. His orbit MRI suggested right oculomotor neuritis due to the presence of diffuse thickening of the right oculomotor nerve with enhancement. Finally, he was diagnosed with syphilis as a result of CSF protein 96.0, VDRL 7.5, and FTA-ABS (+) and was administered penicillin (4,000,000 units) and oral steroid (50 mg). One week after, his intraocular pressure was in the normal range. Extraocular movement examination findings were favorable as a result of 20-prism right exotropia at near and distance in the state of primary deviation and 35-prism right exotropia in the state of secondary deviation. He had extraocular movement disorder only in upper gaze. A diagnosis of neurosyphilis should be considered in patients with serologic evidence of syphilis and one or more of the following cerebrospinal fluid abnormalities; mononuclear pleocytosis, elevated protein, increased immunoglobulin G, or the presence of oligoclonal bands.
Masayuki Takahira - One of the best experts on this subject based on the ideXlab platform.
-
Pseudo-Argyll Robertson Pupil of patients with spinocerebellar ataxia type 1 (SCA1)
Journal of neurology neurosurgery and psychiatry, 1998Co-Authors: Kazunori Mabuchi, Hiroaki Yoshikawa, Masaharu Takamori, Hidehiro Yokoji, Masayuki TakahiraAbstract:A pseudo-Argyll Robertson Pupil is a neurological sign indicating a normal near reflex but the absence of a light reflex (light-near dissociation), a lack of miosis, and Pupil irregularity. It has been reported in patients with diabetes mellitus, multiple sclerosis, Wernicke’s encephalopathy, sarcoidosis, tumours, and haemorrhage.1 Although the appearance of pseudo-Argyll Robertson Pupil is very similar to Holmes-Adie Pupil, the first is distinguishable from the second by the location of lesions and pharmacological response. The responsible lesion in pseudo-Argyll Robertson Pupil is in the central region, whereas that of Holmes-Adie Pupil is peripheral. Dilute pilocarpine constricts the Pupils of patients with Holmes-Adie Pupil, but it is not effective in patients with pseudo-Argyll Robertson Pupil. We present a patient with spinocerebellar ataxia type 1 (SCA1) and her asymptomatic younger brother who both exhibited pseudo-Argyll Robertson Pupil. Patient 1 was a 21 year old woman who complained of gait instability in 1996. Thereafter, she noticed difficulties in speech and in the fine movement of her hands. Her mother had had gait disturbance since her 20s and died of pneumonia at the age of 35. The condition of our patient deteriorated gradually, and she was …
Gordon T. Plant - One of the best experts on this subject based on the ideXlab platform.
-
A Tribute to Douglas Argyll Robertson in the Centenary of his Death: His Achievements, the Influence of his Father and his “Pupil” Today
Neuro-Ophthalmology, 2009Co-Authors: Andrzej Grzybowski, Gordon T. PlantAbstract:Douglas Argyll Robertson (1837–1909) was the first surgeon in Scotland to practice entirely in the field of ophthalmology. He completed his medical education under von Arlt in Prague and Albrecht von Graefe in Berlin. He made major contributions to ophthalmic surgery. He described that in cases of spinal cord disease there may be loss of the Pupil light reflex but retention of the response to accommodation. This condition was named the “Argyll Robertson Pupil” which has become one of the best known physical signs in Neurology. Argyll Robertson can be credited with a large number of other original observations in neuro-ophthalmology and he made a particular contribution to the management of glaucoma both from the discovery of the action of physostigmine (extract of the Calabar bean) and as the first to recommend trephining the sclera in those cases of glaucoma where extensive degenerative changes in the iris made an iridectomy impracticable. Less widely known was the importance of his father (John Argyll R...
-
Douglas Argyll Robertson (1837‐1909) – what did he do other than describe the Argyll Robertson Pupil?
Acta Ophthalmologica, 2008Co-Authors: Andrzej Grzybowski, Gordon T. PlantAbstract:Purpose To study medical achievements of Douglas Argyll Robertson in ophthalmology. Methods The data dealt with in this paper is analysed both from the historical and present-day perspectives. Results Douglas Argyll Robertson (1837-1909) was the first surgeon in Scotland to practice entirely in the field of ophthalmology. In this he was no doubt encouraged by the memory of his father, John Argyll Robertson, who was one of the founders of the Edinburgh Eye Dipensary but who had died when his son was only 18 years of age. Douglas completed his medical education under von Arlt in Prague and Albrecht von Graefe in Berlin. Argyll Robertson made major contributions to ophthalmic surgery. He introduced extracts of Calabar bean (Physostigma venenosum), in the treatment of glaucoma. He also described in cases of spinal cord disease that there may be loss of the light reflex of the Pupil but retention of its movement in accommodation. This condition was named the "Argyll Robertson Pupil" and as a clinical sign is almost always indicative of neurosyphilis. His other contributions include: lupus of the eyelid, aetiology of glaucoma, melanotic tumor, diphtheritic ophthalmia, sympathetic ophthalmia, retinitis pigmentosa, hypertrophy of the lacrimal gland, senile entropion, hydrophthalmos, asteroid hyalitis, pulsating exophthalmos, conjunctival filiariasis, albuminuric retinitis, miner’s nystagmus and microphthalmos. Argyll Robertson is also credited with being the first to recommend trephining the sclera in those cases of glaucoma where extensive degenerative changes in the iris made an iridectomy impracticable. Conclusion As we approach the centenary of his death Argyll Robertson deserves to be celebrated for more than his Pupil.
-
douglas Argyll Robertson 1837 1909 what did he do other than describe the Argyll Robertson Pupil
Acta Ophthalmologica, 2008Co-Authors: Andrzej Grzybowski, Gordon T. PlantAbstract:Purpose To study medical achievements of Douglas Argyll Robertson in ophthalmology. Methods The data dealt with in this paper is analysed both from the historical and present-day perspectives. Results Douglas Argyll Robertson (1837-1909) was the first surgeon in Scotland to practice entirely in the field of ophthalmology. In this he was no doubt encouraged by the memory of his father, John Argyll Robertson, who was one of the founders of the Edinburgh Eye Dipensary but who had died when his son was only 18 years of age. Douglas completed his medical education under von Arlt in Prague and Albrecht von Graefe in Berlin. Argyll Robertson made major contributions to ophthalmic surgery. He introduced extracts of Calabar bean (Physostigma venenosum), in the treatment of glaucoma. He also described in cases of spinal cord disease that there may be loss of the light reflex of the Pupil but retention of its movement in accommodation. This condition was named the "Argyll Robertson Pupil" and as a clinical sign is almost always indicative of neurosyphilis. His other contributions include: lupus of the eyelid, aetiology of glaucoma, melanotic tumor, diphtheritic ophthalmia, sympathetic ophthalmia, retinitis pigmentosa, hypertrophy of the lacrimal gland, senile entropion, hydrophthalmos, asteroid hyalitis, pulsating exophthalmos, conjunctival filiariasis, albuminuric retinitis, miner’s nystagmus and microphthalmos. Argyll Robertson is also credited with being the first to recommend trephining the sclera in those cases of glaucoma where extensive degenerative changes in the iris made an iridectomy impracticable. Conclusion As we approach the centenary of his death Argyll Robertson deserves to be celebrated for more than his Pupil.
Kazunori Mabuchi - One of the best experts on this subject based on the ideXlab platform.
-
Pseudo-Argyll Robertson Pupil of patients with spinocerebellar ataxia type 1 (SCA1)
Journal of neurology neurosurgery and psychiatry, 1998Co-Authors: Kazunori Mabuchi, Hiroaki Yoshikawa, Masaharu Takamori, Hidehiro Yokoji, Masayuki TakahiraAbstract:A pseudo-Argyll Robertson Pupil is a neurological sign indicating a normal near reflex but the absence of a light reflex (light-near dissociation), a lack of miosis, and Pupil irregularity. It has been reported in patients with diabetes mellitus, multiple sclerosis, Wernicke’s encephalopathy, sarcoidosis, tumours, and haemorrhage.1 Although the appearance of pseudo-Argyll Robertson Pupil is very similar to Holmes-Adie Pupil, the first is distinguishable from the second by the location of lesions and pharmacological response. The responsible lesion in pseudo-Argyll Robertson Pupil is in the central region, whereas that of Holmes-Adie Pupil is peripheral. Dilute pilocarpine constricts the Pupils of patients with Holmes-Adie Pupil, but it is not effective in patients with pseudo-Argyll Robertson Pupil. We present a patient with spinocerebellar ataxia type 1 (SCA1) and her asymptomatic younger brother who both exhibited pseudo-Argyll Robertson Pupil. Patient 1 was a 21 year old woman who complained of gait instability in 1996. Thereafter, she noticed difficulties in speech and in the fine movement of her hands. Her mother had had gait disturbance since her 20s and died of pneumonia at the age of 35. The condition of our patient deteriorated gradually, and she was …
Hye In Park - One of the best experts on this subject based on the ideXlab platform.
-
Neurosyphilis Presenting Unilateral Oculomotor Nerve Palsy and Bilateral Pupil Involvement
Journal of Clinical & Experimental Ophthalmology, 2015Co-Authors: Hye In Park, Sung Mo KangAbstract:Of the symptomatic disorders associated with neurosyphilis, the earliest manifestation is syphilitic meningitis. Approximately 5% of patients with secondary syphilis develop associated meningitis. Headaches, meningismus, cranial nerve palsies (chiefly, in descending order of frequency, VII, VIII, VI, and II. Here, we report a case of neurosyphilis presenting as unilateral oculomotor nerve palsy with bilateral Pupil involvement (Argyll-Robertson Pupil). A 43-year-old male presented with diplopia in both eyes at a neurology clinic 2 weeks before. He had right paralytic blepharoptosis, and both Pupils were fixed and both Pupils were not observed direct and indirect reflex and anisocoric. We observed Argyll Robertson Pupil. He had 35 prisms of right exotropia, 2 prisms of right hypertropia at near and distance in the state of primary deviation and 60-prism right exotropia and 4- prism hypertropia in the state of secondary deviation. He had extraocular movement disorder in all gazes except abduction. We considered oculomotor nerve palsy associated with neurosyphilis based on the Argyll Robertson Pupil. His orbit MRI suggested right oculomotor neuritis due to the presence of diffuse thickening of the right oculomotor nerve with enhancement. Finally, he was diagnosed with syphilis as a result of CSF protein 96.0, VDRL 7.5, and FTA-ABS (+) and was administered penicillin (4,000,000 units) and oral steroid (50 mg). One week after, his intraocular pressure was in the normal range. Extraocular movement examination findings were favorable as a result of 20-prism right exotropia at near and distance in the state of primary deviation and 35-prism right exotropia in the state of secondary deviation. He had extraocular movement disorder only in upper gaze. A diagnosis of neurosyphilis should be considered in patients with serologic evidence of syphilis and one or more of the following cerebrospinal fluid abnormalities; mononuclear pleocytosis, elevated protein, increased immunoglobulin G, or the presence of oligoclonal bands.