• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.360-362
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• 2010

A sphenoid mucocele often presents late due to its deep seated anatomical site. And it has varied presentation due to its loose relationship to the cavernous sinus and the base of the skull. We describe a case of large sphenoid sinus mucocele. A middle aged old man suddenly developed third cranial nerve palsy. Brain imaging study revealed an isolated sphenoid sinus mucocele, compressing right cavernous sinus. Endoscopic marsupialization of the mucocele via transnasal approach led to complete resolution of the third cranial nerve palsy. Involvement of the third cranial nerve in isolated mucocele is rare but important neurosurgical implications which must be excluded. In addition, proper and timely treatment must be performed to avoid permanent neurologic deficit.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.118-121
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• 2009

Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident involving a pituitary adenoma or an adjacent pituitary gland. Pituitary apoplexy may be associated with a variety of neurological and endocrinological signs and symptoms. However, isolated third cranial nerve palsy with ptosis as the presenting sign of pituitary apoplexy is very rare. We describe two cases of pituitary apoplexy presenting as sudden-onset unilateral ptosis and diplopia. In one case, brain magnetic resonance imaging (MRI) revealed a mass in the pituitary fossa with signs of hemorrhage, upward displacement of the optic chiasm, erosion of the sellar floor and invasion of the right cavernous sinus. In the other case, MRI showed a large area of insufficient enhancement in the anterior pituitary consistent with pituitary infarction or Sheehan's syndrome. We performed neurosurgical decompression via a transsphenoidal approach. Both patients showed an uneventful recovery. Both cases of isolated third cranial nerve palsy with ptosis completely resolved during the early postoperative period. We suggest that pituitary apoplexy should be included in the differential diagnosis of patients presenting with isolated third cranial nerve palsy with ptosis and that prompt neurosurgical decompression should be considered for the preservation of third cranial nerve function.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.17 no.3
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• pp.126-130
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• 2004

Oculomotor nerve palsy presents itself with sudden onset unilateral ptosis and inability to turn the eye upward, downward, or inward, which causes visual disturbances. Strabismus caused oculomotor nerve palsy refers to muscle imbalance that results in improper alignment of the visual axes of the two eyes It may be divided into paralytic and non paralytic strabismus. paralytic strabismus is primarily a neurologic problem. Characteristic clinical disturbances result from lesions of the third, fourth, and sixth cranial nerves. Lesions of the third nerve result in a paralysis of lateral or outward movement and a crossing of the visual axes. Objective: This study was designed to evaluate the effects of oriental medicine therapy on a peripheral oculomotor nerve palsy. Methods & Result: The clinical data was analyzed on a patient with oculomotor nerve palsy whose main symptoms were right side ptosis and inability to turn the eye inward. The patient was treated by the electroacupucture(4Hz frequency, intensity was adjusted so that localized muscle contractions could be seen). As the result, symptoms are improved remarkably. Conclusion: The patient showed right eye ptosis and unilateral deviation of the right eye ball in neutral position. After acupuncture treatment and electroacupuncture treatment, the ptosis and deviation of the patient's right eye was recovered six weeks after the onset. The study suggests that oriental medicine therapy is significantly effective on the treatment of peripheral oculomotor nerve palsy.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.16 no.1
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• pp.168-178
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• 2003

Strabismus refers to a extra-ocular muscle imbalance that results in improper alignment of the visual axes of two eyes. It may be divided into paralytic and non-paralytic strabismus. Paralytic strabismus is primarily a neurological problem: non-paralytic strabismus is more strictly an ophthalmologic problem. This case report focuses on paralytic strabismus resulting from palsies of the third and the sixth cranial nerves, respectively. Oculomotor nerve palsies result in binocular diplopia with characteristic patterns of strabismus. Oculomotor nerve provides motor and parasympathetic innervation to the eyes. Acquired oculomotor nerve palsies are not uncommon. Injury to the third nerve may result in complete or partial dysfunction. Complete third nerve palsy is manifested by ptosis, dilated pupil, an eye that is deviated down and out in primary position, and limited adduction, elevation, and depression. Patients with unilateral sixth nerve palsy complain of binocular, horizontal diplopia esotropia in the primary position due to unopposed action of the medial rectus and limitation of abduction due to weakness of the lateral rectus. Diplopia is worse in the direction of the paretic lateral rectus muscle. Paralytic strabismus are treated, based on the theory of Oriental medicine. with berbal medicines having gun-bi(健脾), bae-to(培土), gue-pung(祛風) effect of acupuncture around the eyes and etc. We describe a 63-year-old woman with complete the 3rd cranial nerve palsy and a 32-year-old woman with the unilateral 6th cranial nerve palsy who treated with acupuncture and herbal medicines and showed complete recovery.

• Journal of Oriental Neuropsychiatry
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• v.12 no.1
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• pp.201-207
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• 2001

Oculomotor nerve is the third cranial nerve, controlls four of the six extraocular muscles(superior rectus muscle, medial rectus muscle, inferior rectus muscle and inferior oblique muscle), levator palpebrae superioris muscle, cilliary muscle and muscle sphincter pupillae. In the oculomotor nerve palsy, limited oculogyration, diplopia, blepharoptosis, accomodation paralysis and mydriasis can be occured. We experienced an improved case of the oculomotor nerve palsy patient treated with oriental medicine for 25days. We used herbal medicine and acupuncture. Based on this experience, it is considered that oriental medicine can be applied to the treatment of the oculomotor nerve palsy.

• Annals of Clinical Neurophysiology
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• v.10 no.1
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• pp.79-82
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• 2008

The etiology of intractable hiccups is most commonly idiopathic. However, they are occasionally associated with some underlying disorders including gastro-esophageal reflux disease. There are a few previous reports describing the association of intractable hiccups with high dose corticosteroid. We experienced an unusual case of intractable hiccups following a high dose intravenous methylprednisolone therapy in a patient with right third nerve palsy. Since methylprednisolone is commonly used in various neurological problems, physicians should be aware of its possible side effect including intractable hiccups.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.242-246
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• 2002

A case of a peroneal nerve palsy caused by repeatedly recurred intraneural ganglion cyst is presented. A 19 year old male suffered from tingling sensation on the foot dorsum more than one year and underwent two times of mass excision and nerve palsy was recorvered. But it was recurred once more after 10 months after the second excision. The mass was located in the fibro-osseous tunnel against the fibular neck and the origin of the peroneus longus. The third complete excision was done and full recovery was obtained in 6 months.

• Journal of Acupuncture Research
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• v.41 no.1
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• pp.53-62
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• 2024

Background: The aim of this study is to determine the correlation between clinical assessment scales, self-assessment scales, and surface electromyography (SEMG) for facial nerve palsy. Methods: This study assessed 32 cases of facial nerve palsy on the first visit, 11 cases on the second visit, and 9 cases on the third visit to the Korean medicine hospital, university. This study was conducted from October 22, 2022, to December 22, 2022. The patients were evaluated using SEMG, clinical assessment scales, and self-assessment scales 3 times. The House-Brackmann grading systems (HBGS), Yanagihara unweighted grading system (Y-score), facial disability index, numerous rating scale, and accompanying symptoms of facial nerve palsy were used for assessment. Moreover, statistical correlation was analyzed using Pearson correlation. Results: On Visit 1, Significant correlations were observed between the results of SEMG and other clinical assessment scales as well as between SEMG-F (frontalis) and different parts of the Y-score. On Visit 2, significant correlations were observed between the results of SEMG and HBGS as well as between SEMG-F and the detailed parts of the Y-score. On Visit 3, significant correlations were observed only between SEMG-F and the detailed parts of the Y-score. A significant correlation was also observed between the changes in the clinical assessment scales on Visits 1 and 3 and between the changes in SEMG-F and those in the patient self-assessment scales. Conclusion: These findings suggest that SEMG can be used to evaluate facial nerve palsy in conjunction with the use of other clinical assessment scales.

• The Journal of Internal Korean Medicine
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• v.26 no.3
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• pp.670-676
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• 2005

The purpose of this case study is to present a case of oculolmotor nerve palsy due to midbrain infarction improved by acupuncture and herb medicine. Oculomotor nerve palsy is a disorder associated with dysfunction in the third cranial nerve, which causes eye movement disorder, diplopia and ptosis. The patient, who was diagnosed with Benedikt's Syndrome(Red Nucleus Syndrome), was given oriental medical treatment. Benetikt's Syndrome has the various symptoms of weakness on one side(contralateral) and eye movement disorder, ptosis, diplopia(ipsilateral) etc., but research on Benetikt's Syndrome or midbrain infarction is scant. Results of this study suggest a role for conservative therapy with herb medicine and acupuncture to treat oculomotor nerve palsy(eye movement disorder, ptosis, diplopia, etc., ipsilateral) and right motor weakness(contralateral) due to midbrain infarction. Further research into oriental medical treatment for such disorders will be forthcoming.

• Journal of Korean Neurosurgical Society
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• v.48 no.2
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• pp.115-118
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• 2010

Objective : Cerebral aneurysms which cause oculomotor nerve [cranial nerve (CN) III] palsy, are frequently found with a daughter sac of the aneurysm dome. We assumed that CN III might be compressed by the daughter sac and it would be more helpful not to fill the daughter sac with coils than vice versa during endosaccular embolization for recovering from CN III palsy, because it may give a greater chance for the daughter sac to shrink by itself later. We reviewed the initial results of our experiences of such cases. Methods : Among 9 aneurysms accompanied by CN III palsy, 7 (6 unruptured, 1 ruptured) showed a daughter sac. We tried to fill the main dome completely and spare the daughter sac from coil filling to increase the possibility of decompression. We evaluated the short-term effectiveness of this concept using medical records and angiograms. Results : After initial embolization, all of CN III palsy caused by unruptured aneurysms (6/6) resolved completely after various periods (3-90 days) of time. No adverse effects were noted during and after the procedures except for one case of harmless coil stretching during coil filling using double microcatheter. Conclusion : During the coil embolization of the cerebral aneurysm causing CN III palsy, sparing the daughter sac from coil packing while tightly packing the main dome, can be helpful in increasing the effectiveness of decompression. However, a long-term follow-up will be required.