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1. Boulis NM, Noordmans AJ, Barkan A, Hassing J, Chandler WF: Somatotropinoma infarction during octreotide therapy leading to bilateral cavernous sinus syndrome. Pituitary; 2000 Nov;3(3):185-8
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  • In addition to lowering circulating growth hormone levels and shrinking tumor size, octreotide may provide symptomatic relief of headaches associated with growth hormone secreting tumors.
  • Serial MRI examination suggest tumor infarction as the etiology.
  • The symptoms resolved over 2 months as the tumor shrunk in size and growth hormone was dramatically reduced.
  • [MeSH-major] Cavernous Sinus. Cerebral Infarction / chemically induced. Cranial Nerve Diseases / chemically induced. Human Growth Hormone / secretion. Octreotide / adverse effects. Ophthalmoplegia / chemically induced. Pituitary Neoplasms / chemically induced. Pituitary Neoplasms / secretion
  • [MeSH-minor] Abducens Nerve / drug effects. Child. Female. Humans. Magnetic Resonance Imaging. Oculomotor Nerve / drug effects. Syndrome

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  • (PMID = 11383484.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; RWM8CCW8GP / Octreotide
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2. Leiba H, Wirth GM, Amstutz C, Landau K: Long-term results of vertical rectus muscle transposition and botulinum toxin for sixth nerve palsy. J AAPOS; 2010 Dec;14(6):498-501
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  • [Title] Long-term results of vertical rectus muscle transposition and botulinum toxin for sixth nerve palsy.
  • PURPOSE: To report the long-term outcome of full-tendon vertical rectus muscle transposition combined with chemodenervation of the ipsilateral medial rectus muscle for acquired chronic sixth (abducens) nerve palsy.
  • The etiologies for the palsy were head trauma (11), tumor (10), and idiopathic (1).
  • CONCLUSIONS: Vertical rectus muscle transposition combined with intraoperative botulinum toxin injection into the ipsilateral medial rectus muscle improved alignment in patients with complete chronic sixth nerve palsy.

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  • [Copyright] Copyright © 2010 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.
  • (PMID = 21094068.001).
  • [ISSN] 1528-3933
  • [Journal-full-title] Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
  • [ISO-abbreviation] J AAPOS
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Dyskinesia Agents; EC 3.4.24.69 / Botulinum Toxins
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3. Kau HC, Tsai CC: Abducens ocular neuromyotonia in a patient with nasopharyngeal carcinoma following concurrent chemoradiotherapy. J Neuroophthalmol; 2010 Sep;30(3):266-7
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  • [Title] Abducens ocular neuromyotonia in a patient with nasopharyngeal carcinoma following concurrent chemoradiotherapy.
  • We describe a case of ocular neuromyotonia (ONM) following concurrent chemoradiotherapy for nasopharyngeal carcinoma (NPC).
  • In the quiescent period, ocular motor examination revealed a partial left sixth nerve palsy.
  • While diplopic complaints in patients with NPC raise suspicion of tumor recurrence or radiation-related cranial neuropathy, ONM must also be kept in the differential diagnosis.
  • [MeSH-major] Abducens Nerve Diseases / etiology. Drug-Related Side Effects and Adverse Reactions. Ocular Motility Disorders / etiology. Radiotherapy / adverse effects
  • [MeSH-minor] Antineoplastic Agents / adverse effects. Carcinoma / therapy. Cisplatin / adverse effects. Diplopia / etiology. Female. Fluorouracil / adverse effects. Humans. Immunosuppressive Agents / adverse effects. Middle Aged. Nasopharyngeal Neoplasms / therapy


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4. Kerr NC, Hoehn MB: Botulinum toxin for sixth nerve palsies in children with brain tumors. J AAPOS; 2001 Feb;5(1):21-5
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  • [Title] Botulinum toxin for sixth nerve palsies in children with brain tumors.
  • PURPOSE: Sixth nerve palsies in children with brain tumors have a low rate of spontaneous recovery.
  • Botulinum toxin has been used to treat sixth nerve palsies.
  • In this study, we review outcomes for children with brain tumors and sixth nerve palsies, some of whom were treated with botulinum toxin.
  • METHODS: To determine whether botulinum toxin effected the outcome of children with sixth nerve palsies and brain tumors, a retrospective review of charts was conducted for patients identified as having brain tumors and sixth nerve palsies after evaluation at the St Jude Children's Research Hospital Eye Clinic between 1992 and 1999.
  • Of 48 charts identified, 19 met our inclusion criteria, having a record of brain tumor associated with sixth nerve palsy and 2 or more eye clinic visits at least 6 months apart.
  • RESULTS: Of the 19 children included in the study, 10 were managed conservatively (no botulinum toxin or surgery for at least 6 months after diagnosis).
  • CONCLUSIONS: Treatment with botulinum toxin did not improve the rate of recovery in our series of children with brain tumors and sixth nerve palsies.

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  • (PMID = 11182668.001).
  • [ISSN] 1091-8531
  • [Journal-full-title] Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
  • [ISO-abbreviation] J AAPOS
  • [Language] ENG
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Dyskinesia Agents; EC 3.4.24.69 / Botulinum Toxins
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5. Koop G, Gräf M: [Ocular neuromyotonia]. Klin Monbl Augenheilkd; 2006 Mar;223(3):247-51
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  • [Title] [Ocular neuromyotonia].
  • BACKGROUND: Ocular neuromyotonia is a rare ocular motility disorder characterized by involuntary contractions of one or several ocular motor muscles.
  • PATIENT AND METHODS: A 61-year-old female patient was referred with persistent diplopia despite previous surgical treatment for right 6 (th) nerve palsy.
  • The results coincide with data collected in our department from three other patients with ocular neuromyotonia (2 cranial nerve VI, 1 cranial nerve IV), over the past three years.
  • The gaze to the left led to a retraction instead of an adduction of the right eye.
  • CONCLUSIONS: These typical findings permit the diagnosis of ocular neuromyotonia.
  • The characteristic symptoms of ocular neuromyotonia and the typical history of a previous intracranial tumor, treated neurosurgically with adjuvant radiotherapy, lead to the hypothesis that ephaptic transmission in the cranial nerve is the underlying pathophysiological mechanism in the development of ocular neuromyotonia.
  • [MeSH-major] Isaacs Syndrome / diagnosis. Ocular Motility Disorders / diagnosis
  • [MeSH-minor] Abducens Nerve Diseases / surgery. Carbamazepine / therapeutic use. Combined Modality Therapy. Diplopia / etiology. Female. Humans. Middle Aged. Postoperative Complications / diagnosis. Postoperative Complications / drug therapy. Strabismus / diagnosis. Strabismus / drug therapy

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  • (PMID = 16552659.001).
  • [ISSN] 0023-2165
  • [Journal-full-title] Klinische Monatsblätter für Augenheilkunde
  • [ISO-abbreviation] Klin Monbl Augenheilkd
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 33CM23913M / Carbamazepine
  • [Number-of-references] 36
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6. Yamada S, Fukuhara N, Oyama K, Takeshita A, Takeuchi Y: Repeat transsphenoidal surgery for the treatment of remaining or recurring pituitary tumors in acromegaly. Neurosurgery; 2010 Oct;67(4):949-56
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  • [Title] Repeat transsphenoidal surgery for the treatment of remaining or recurring pituitary tumors in acromegaly.
  • BACKGROUND: Acromegaly is a disorder characterized by hypersecretion of growth hormone caused by a growth hormone-secreting pituitary adenoma.
  • Furthermore, 17 patients were well controlled with normal insulin-like growth factor I levels without (2 patients) or with medication (15 patients), whereas insulin-like growth factor I levels were still above normal in 5 patients after postoperative adjuvant therapy.
  • Only 1 patient was undergoing additional hormonal replacement after surgery, although transient cerebrospinal fluid leak, transient abducens nerve palsy, severe nasal bleeding, and pituitary abscess occurred in each patient, respectively.
  • Multivariate analysis clarified that a favorable surgical outcome was achieved in patients without cavernous sinus invasion (hazard ratio 12.56), tumor segmentation (hazard ratio 5.82), or in those older than 40 years old (hazard ratio 3.21).
  • [MeSH-major] Acromegaly / etiology. Acromegaly / surgery. Growth Hormone / secretion. Hypophysectomy / adverse effects. Pituitary Neoplasms / complications

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  • (PMID = 20881560.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-72-6 / Growth Hormone
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7. Yamaguchi S, Terasaka S, Ando S, Shinohara T, Iwasaki Y: Neoadjuvant therapy in a patient with clival plasmacytoma associated with multiple myeloma: a case report. Surg Neurol; 2008 Oct;70(4):403-7
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  • CASE DESCRIPTION: We report a 65-year-old woman who presented with a large clival plasmacytoma causing right trigeminal and abducens nerve palsies and was diagnosed with MM after transsphenoidal biopsy.
  • She underwent neoadjuvant chemoradiotherapy followed by radical resection of the residual tumor.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy. Neoadjuvant Therapy. Plasmacytoma / drug therapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Cranial Fossa, Posterior / pathology. Dexamethasone / therapeutic use. Doxorubicin / therapeutic use. Female. Humans. Magnetic Resonance Imaging. Neurosurgical Procedures. Salvage Therapy. Vincristine / therapeutic use

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  • (PMID = 18291467.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; VAD I protocol
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8. Gómez De Liaño Sánchez P, Villarejo Díaz-Maroto I, Gómez De Liaño Sánchez R, Bonales Domínguez A, Valls Ferrán I, Alzamora Rodríguez A: [Treatment of sixth nerve palsy of traumatic or tumor etiology using botulinum toxin]. Arch Soc Esp Oftalmol; 2000 Jul;75(7):471-6
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  • [Title] [Treatment of sixth nerve palsy of traumatic or tumor etiology using botulinum toxin].
  • [Transliterated title] Tratamiento de las parálisis del VI par de etiología traumática y tumoral mediante toxina botulínica.
  • PURPOSE: To study the treatment of sixth nerve palsies of traumatic or tumoral etiologies using botulinum toxin.
  • METHODS: 35 patients with unilateral sixth nerve palsy are studied, 21 presenting traumatic (group I) and 14 with tumoral etiology (group II).
  • It is also useful as a chronic treatment and as a diagnosis procedure.
  • [MeSH-major] Abducens Nerve Diseases / drug therapy. Abducens Nerve Injury / drug therapy. Botulinum Toxins / therapeutic use
  • [MeSH-minor] Adolescent. Adult. Aged. Cranial Nerve Neoplasms / complications. Humans. Middle Aged

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  • (PMID = 11151199.001).
  • [ISSN] 0365-6691
  • [Journal-full-title] Archivos de la Sociedad Española de Oftalmología
  • [ISO-abbreviation] Arch Soc Esp Oftalmol
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
  • [Chemical-registry-number] EC 3.4.24.69 / Botulinum Toxins
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9. Koizumi H, Oka H, Utsuki S, Sato S, Tanizaki Y, Shimizu S, Suzuki S, Iizuka T, Sakai F, Fujii K: Primary germinoma arising from the midbrain. Acta Neurochir (Wien); 2006 Nov;148(11):1197-200; discussion 1200
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  • A 29-year-old man presented with diplopia, dysarthria, anisocoria, oculomotor nerve paralysis, abducens nerve paralysis, right facial palsy, and spastic hemiparetic gait.
  • MRI-guided stereotactic biopsy was performed, and the histologic diagnosis was pure germinoma.
  • The tumor disappeared after chemotherapy and radiotherapy.
  • Germinoma should be included in the differential diagnosis of midbrain lesions in young adults.
  • MRI-guided stereotactic biopsy provided a helpful diagnostic clue in a patient with a midbrain lesion.
  • [MeSH-major] Brain Stem Neoplasms / diagnosis. Brain Stem Neoplasms / therapy. Germinoma / diagnosis. Germinoma / therapy. Mesencephalon / pathology
  • [MeSH-minor] Adult. Anisocoria / etiology. Anisocoria / pathology. Anisocoria / physiopathology. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy. Diplopia / etiology. Diplopia / pathology. Diplopia / physiopathology. Drug Therapy. Humans. Magnetic Resonance Imaging. Male. Neuronavigation. Oculomotor Nerve Diseases / etiology. Oculomotor Nerve Diseases / pathology. Oculomotor Nerve Diseases / physiopathology. Radiotherapy. Treatment Outcome

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  • (PMID = 17039305.001).
  • [ISSN] 0001-6268
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Austria
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10. Grau S, Schueller U, Weiss C, Tonn JC: Primary meningeal T-cell lymphoma at the clivus mimicking a meningioma. World Neurosurg; 2010 Oct-Nov;74(4-5):513-6
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  • BACKGROUND: Most primary lymphomas of the central nervous system (CNS) are of B-cell origin and are found intra-axially, with a few reported cases of skull base tumors involving the upper clivus or sellar region or both.
  • In this case, a tumor resembling a clivus meningioma without osseous involvement was surgically removed and turned out to be a primary T-cell lymphoma.
  • CASE REPORT: A 60-year-old woman presented with slight right-sided abducens nerve palsy.
  • Cranial imaging revealed an extra-axial mass at the caudal clivus resembling a meningioma.
  • The tumor was removed surgically; smear preparations obtained intraoperatively were inconclusive presumably because of preoperative steroid treatment.
  • The final diagnosis was peripheral T-cell lymphoma, not otherwise unspecified.
  • CONCLUSIONS: Although a very rare entity among primary T-cell lymphomas of the CNS, these tumors also can occur as skull base lesions without involvement of the bone.
  • Preoperative steroid medication may complicate intraoperative histologic assessment and lead to inadequate treatment of these tumors.
  • [MeSH-major] Cranial Fossa, Posterior / surgery. Infratentorial Neoplasms / diagnosis. Lymphoma, T-Cell / diagnosis. Meningeal Neoplasms / diagnosis. Meningioma / diagnosis. Skull Base Neoplasms / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Female. Humans. Middle Aged

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  • [Copyright] Copyright © 2010 Elsevier Inc. All rights reserved.
  • (PMID = 21492604.001).
  • [ISSN] 1878-8769
  • [Journal-full-title] World neurosurgery
  • [ISO-abbreviation] World Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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