Painful ophthalmoplegia can be caused by numerous pathologic conditions such as aneurysm; neoplasms such as chondrosarcoma, lymphoma, and nasopharyngeal carcinoma; diabetes mellitus; infection; and inflammatory disorders such as sarcoidosis and TolosaHunt syndrome (THS). Described by Tolosa in 1954 and Hunt et al in 1961, THS is an idiopathic, selflimited inflammatory disorder characterized by ...

OBJECTIVE To describe the clinical phenotype and genetic basis of a family with autosomal dominant progressive external ophthalmoplegia and parkinsonism from a Twinkle mutation. DESIGN All coding exons of POLG1, Twinkle (aka C10ORF2, PEO1), and ANT1 (SLC25A4) were sequenced in the proband with targeted sequencing of the Twinkle gene in all additional subjects. SUBJECTS Members of a 3-genera...

An 18-year-old woman with poorly controlled insulindependent diabetes mellitus had 3 days of worsening nasal discharge, right facial pain and erythema, and headache. Lumbar puncture showed 250 nucleated cells/ L with neutrophil predominance, elevated protein of 81 mg/dL, and normal glucose. She was treated for presumed meningitis, but then rapidly developed right-side symptoms including facial ...

BACKGROUND Vertebrobasilar dolichoectasia (VBD) is a complex progressive arterial disease characterized by dilation, elongation, and tortuosity of the vertebral and basilar arteries, and may be congenital or acquired. VBD may lead to progressive compression of the brainstem, cranial nerve abnormalities, and intracranial hemorrhage, but may also be associated with arterial thrombosis, with ische...

Miller Fisher's syndrome (MFS) commonly presents in the fourth and fifth decades and are rare in people over 70 years. An 85-year-old female with no significant medical history presented with upper extremity anesthesia, ptosis, and unsteady gait. The patient had a history of hypertension and diabetes mellitus. Physical examination showed bilateral total external ophthalmoplegia, areflexia, and ...

Tetanus is a neurologic disorder caused by tetanospasmin, a protein toxin elaborated by Clostridium tetani. Cephalic tetanus is a localized form of the disease causing trismus and dysfunction of cranial nerves. We report the case of a man who presented with facial trauma, complete ophthalmoplegia, exophthalmos, areactive mydriasis, and periorbital hematoma. An orbital CT revealed air bubbles in...