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Conjugate Gaze Palsy
Conjugate gaze palsies are neurological disorders affecting the ability to move both eyes in the same direction. These palsies can affect gaze in a horizontal, upward, or downward direction. These entities overlap with ophthalmoparesis and ophthalmoplegia. Signs and symptoms Symptoms of conjugate gaze palsies include the impairment of gaze in various directions and different types of movement, depending on the type of gaze palsy. Signs of a person with a gaze palsy may be frequent movement of the head instead of the eyes. For example, a person with a horizontal saccadic (saccade) palsy may jerk their head around while watching a movie or high action event instead of keeping their head steady and moving their eyes, which usually goes unnoticed. Someone with a nonselective horizontal gaze palsy may slowly rotate their head back and forth while reading a book instead of slowly scanning their eyes across the page. Cause A lesion, which is an abnormality in tissue due to injury ...
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Neurology
Neurology (from , "string, nerve" and the suffix wikt:-logia, -logia, "study of") is the branch of specialty (medicine) , medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the nervous system, which comprises the Human brain, brain, the spinal cord and the peripheral nervous system , peripheral nerves. Neurological practice relies heavily on the field of neuroscience, the scientific study of the nervous system, using various techniques of neurotherapy. IEEE Brain (2019). "Neurotherapy: Treating Disorders by Retraining the Brain". ''The Future Neural Therapeutics White Paper''. Retrieved 23.01.2025 from: https://brain.ieee.org/topics/neurotherapy-treating-disorders-by-retraining-the-brain/#:~:text=Neurotherapy%20trains%20a%20patient's%20brain,wave%20activity%20through%20positive%20reinforcement International Neuromodulation Society, Retrieved 23 January 2025 from: https://www.neuromodulation.com/ Val Danilov I (2023). "The O ...
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Medial Rectus Muscle
The medial rectus muscle is a muscle in the orbit near the eye. It is one of the extraocular muscles. It originates from the common tendinous ring, and inserts into the anteromedial surface of the eye. It is supplied by the inferior division of the oculomotor nerve (III). It rotates the eye medially (adduction). Structure The medial rectus muscle shares an origin with several other extrinsic eye muscles, the common tendinous ring. It inserts into the anteromedial surface of the eye. This insertion has a width of around 11 mm. Nerve supply The medial rectus muscle is supplied by the inferior division of the oculomotor nerve (III). A branch of it enters the muscle around two fifths along its length. It usually divides into 2 smaller branches, occasionally 3. These further subdivide, becoming smaller down the length of the muscle until they become imperceptible to standard staining around 17 mm from the insertion of the muscle. Relations The insertion of the medial rectus mu ...
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Eye Diseases
This is a partial list of human eye diseases and disorders. The World Health Organization (WHO) publishes a classification of known diseases and injuries, the International Statistical Classification of Diseases and Related Health Problems, or ICD-10. This list uses that classification. H00-H06 Disorders of eyelid, lacrimal system and orbit * (H02.1) Ectropion * (H02.2) Lagophthalmos * (H02.3) Blepharochalasis * (H02.4) Ptosis (eyelid), Ptosis * (H02.5) Stye, an acne type infection of the sebaceous glands on or near the eyelid. * (H02.6) Xanthelasma of eyelid * (H03.0*) Parasitic infestation of eyelid in diseases classified elsewhere ** Dermatitis of eyelid due to Demodex species ( B88.0+ ) ** Parasitic infestation of eyelid in: *** leishmaniasis ( B55.-+ ) *** loiasis ( B74.3+ ) *** onchocerciasis ( B73+ ) *** phthiriasis ( B85.3+ ) * (H03.1*) Involvement of eyelid in other infectious diseases classified elsewhere ** Involvement of eyelid in: *** herpesviral (herpes simplex) ...
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Ischemic Optic Neuropathy
Ischemic optic neuropathy (ION) is the loss of structure and function of a portion of the optic nerve due to obstruction of blood flow to the nerve (i.e. ischemia). Ischemic forms of optic neuropathy are typically classified as either anterior ischemic optic neuropathy or posterior ischemic optic neuropathy according to the part of the optic nerve that is affected. People affected will often complain of a loss of visual acuity and a visual field, the latter of which is usually in the superior or inferior field. When ION occurs in patients below the age of 50 years old, other causes should be considered, such as juvenile diabetes mellitus, antiphospholipid antibody-associated clotting disorders, collagen-vascular disease, and migraines. Rarely, complications of intraocular surgery or acute blood loss may cause an ischemic event in the optic nerve. Presentation Anterior ION presents with sudden, painless visual loss, developing over hours to days. Diagnosis Examination find ...
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Optic Neuritis
Optic neuritis (ON) is a debilitating condition that is defined as inflammation of cranial nerve II which results in disruption of the neurologic pathways that allow visual sensory information received by the retina to be able to be transmitted to the visual cortex of the brain. This disorder of the optic nerve may arise through various pathophysiologic mechanisms, such as through Demyelinating disease, demyelination or inflammation, leading to partial or total loss of vision. Optic neuritis may be a result of standalone idiopathic disease, but is often a manifestation that occurs secondary to an underlying disease. Signs of ON classically present as sudden-onset visual impairment in one or both eyes that can range in severity from mild visual blurring to complete blindness in the affected eye(s). Although pain is typically considered a hallmark feature of optic neuritis, the absence of pain does not preclude a diagnosis or consideration of ON as some patients may report painlessne ...
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Facial Colliculus
The facial colliculus is an elevated area located in the pontine tegmentum (dorsal pons), within the floor of the fourth ventricle (i.e. the rhomboid fossa). It is formed by fibres from the facial motor nucleus looping over the abducens nucleus. The facial colliculus is an essential landmark of the rhomboid fossa. Anatomy The facial colliculus occurs within the rhomboid fossa (i.e. the floor of the fourth ventricle) where it is placed lateral to its (midline) median sulcus. Structure The facial colliculus is formed by brachial motor nerve fibres of the facial nerve (CN VII) looping over the (ipsilateral) abducens nucleus, forming a bump upon the surface. Clinical significance A facial colliculus lesion would result in ipsilateral facial paralysis (i.e. Bell's palsy Bell's palsy is a type of facial paralysis that results in a temporary inability to control the facial muscles on the affected side of the face. In most cases, the weakness is temporary and significantly ...
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Horizontal Gaze Palsy
A horizontal gaze palsy is a subtype of gaze palsy in which conjugate, horizontal eye movements are limited by neurologic deficits. Horizontal gaze palsies typically result from an ipsilateral pontine lesion or a contralateral frontal lobe lesion. Clinical features Individuals suffering from complete horizontal gaze palsy cannot move either eye past the midline in a single direction. The eyes of a patient with pontine lesions involving the sixth nerve nucleus or PPRF may stray from the lesion's side. Patients with a left pontine lesion will be unable to look to their left and may have their eyes deviated to the right at baseline. If there is only partial damage to the pontine structures, patients may exhibit partial horizontal gaze movement. Patients with horizontal gaze palsy may also have to turn their heads toward the affected side to focus on an object that is directly in front of them because their eyes are constantly shifted to the opposite side. Lesions in the frontal ...
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Nystagmus
Nystagmus is a condition of involuntary (or voluntary, in some cases) Eye movement (sensory), eye movement. People can be born with it but more commonly acquire it in infancy or later in life. In many cases it may result in visual impairment, reduced or limited vision. In normal eyesight, while the Human head, head rotates about an Axis of rotation, axis, distant visual images are sustained by rotating eyes in the opposite direction of the respective axis. The semicircular canals in the vestibule of the ear sense angular acceleration, and send signals to the nuclei for eye movement in the brain. From here, a signal is relayed to the extraocular muscles to allow one's gaze to fix on an object as the head moves. Nystagmus occurs when the semicircular canals are stimulated (e.g., by means of the caloric test, or by disease) while the head is stationary. The direction of ocular movement is related to the semicircular canal that is being stimulated. There are two key forms of nystagm ...
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Medial Longitudinal Fasciculus
The medial longitudinal fasciculus (MLF) is a prominent bundle of nerve fibres which pass within the ventral/anterior portion of periaqueductal gray of the mesencephalon (midbrain). It contains the interstitial nucleus of Cajal, responsible for oculomotor control, head posture, and vertical eye movement. The MLF interconnects interneurons of each abducens nucleus with motor neurons of the contralateral oculomotor nucleus; thus, the MLF mediates coordination of horizontal (side to side) eye movements, ensuring the two eyes move in unison (thus also enabling saccadic eye movements). The MLF also contains fibers projecting from the vestibular nuclei to the oculomotor and trochlear nuclei as well as the interstitial nucleus of Cajal; these connections ensure that eye movements are coordinated with head movements (as sensed by the vestibular system). The medial longitudinal fasciculus is the main central connection for the oculomotor nerve, trochlear nerve, and abduce ...
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One And A Half Syndrome
The one and a half syndrome is a rare weakness in eye movement affecting both eyes, in which one cannot move laterally at all, and the other can move only in outward direction. More formally, it is characterized by "''a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other''". Nystagmus is also present when the eye on the opposite side of the lesion is abducted. Convergence is classically spared as cranial nerve III (oculomotor nerve) and its nucleus is spared bilaterally. Causes Causes of the one and a half syndrome include pontine haemorrhage, ischemia, tumors, infective mass lesions such as tuberculomas, demyelinating conditions like multiple sclerosis, Arteriovenous malformation, Basilar artery aneurysms and Trauma. Anatomy The syndrome usually results from single unilateral lesion of the paramedian pontine reticular formation and the ipsilateral medial longitudinal fasciculus. An alternative anatomical cause is a lesion of t ...
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Oculomotor Nucleus
The fibers of the oculomotor nerve arise from a nucleus in the midbrain, which lies in the gray substance of the floor of the cerebral aqueduct and extends in front of the aqueduct for a short distance into the floor of the third ventricle. From this nucleus the fibers pass forward through the tegmentum, the red nucleus, and the medial part of the substantia nigra, forming a series of curves with a lateral convexity, and emerge from the oculomotor sulcus on the medial side of the cerebral peduncle. The nucleus of the oculomotor nerve does not consist of a continuous column of cells, but is broken up into a number of smaller nuclei, which are arranged in two groups, anterior and posterior. Those of the posterior group are six in number, five of which are symmetrical on the two sides of the middle line, while the sixth is centrally placed and is common to the nerves of both sides. The anterior group consists of two nuclei, an antero-medial and an antero-lateral. The nucleus ...
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Efferent Nerve Fiber
Efferent nerve fibers are axons (nerve fibers) of efferent neurons that exit a particular region. These terms have a slightly different meaning in the context of the peripheral nervous system (PNS) and central nervous system (CNS). The efferent fiber is a long process projecting far from the neuron's body that carries nerve impulses away from the central nervous system toward the peripheral effector organs (muscles and glands). A bundle of these fibers constitute an efferent nerve. The opposite direction of neural activity is afferent conduction, which carries impulses by way of the afferent nerve fibers of sensory neurons. In the nervous system, there is a "closed loop" system of sensation, decision, and reactions. This process is carried out through the activity of sensory neurons, interneurons, and motor neurons. In the CNS, afferent and efferent projections can be from the perspective of any given brain region. That is, each brain region has its own unique set of affe ...
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