Hey there, first year med student here. I wanted some clarity on partial CNIII palsies. I know that somatic motor fibers innervating EOM muscles travel more centrally while parasympathetics fibers travel more peripherally. As such, vascular insults like ischemia tend to affect the central somatic motor fibers first and can result in EOM deficits (divergent strabismus) without pupillary constriction being affected. On the other hand, compressive insults such as aneurysms and tumors affect the peripheral parasympathetic fibers first. This may result in mydriasis/dilated pupil with intact EOMs as somatic motor fibers are unaffected. Is my understanding of vascular insults vs compressive insults and partial CNIII palsies correct? Does this generally hold true in clinical practice? Thank you!
i need help...these docs here in maryland ...including john hopkins can not figure out why my eyes are doing what they are doing....they do not converge....i have dbl vision, both eyes open....ptosis right eye.....frontalis muscles on the right are barely working....left eye doesnt go left.....i have a neuro ophthalmologist....been to an ophthalmologist.....optometrist, at the VA who really helped get me into a pair of prisms or i wouldnt be able to see a single vision on this screen.... i have in my records convergence insufficiency ... progressive external ophthalmoplegia of both eyes....diplopia....alternating exotropia....ptosis....to name a few .....and i am still at square one for knowing why this is happening.....
I saw dr. Golnick last year for diplopia who retired this year. He was thinking possible OMG but also a 4th cranial nerve. It went away after 3 months so we left it alone then came back again this year exactly 1 yr later and here 2 months into it it's starting to go away again. I'm baffled. Any ideas ? I'm guessing this isn't typical for MG? Thanks 👍BTW no other symptoms. testing is normal MRI and all blood work
you are amazing and literate in a different way ...Greaaaaate
Hey there, first year med student here. I wanted some clarity on partial CNIII palsies. I know that somatic motor fibers innervating EOM muscles travel more centrally while parasympathetics fibers travel more peripherally.
As such, vascular insults like ischemia tend to affect the central somatic motor fibers first and can result in EOM deficits (divergent strabismus) without pupillary constriction being affected. On the other hand, compressive insults such as aneurysms and tumors affect the peripheral parasympathetic fibers first. This may result in mydriasis/dilated pupil with intact EOMs as somatic motor fibers are unaffected.
Is my understanding of vascular insults vs compressive insults and partial CNIII palsies correct? Does this generally hold true in clinical practice?
Thank you!
Your Videos are the Best🙌🏾🙏🏽
Hope you're well doc ❤. Love you.
i need help...these docs here in maryland ...including john hopkins can not figure out why my eyes are doing what they are doing....they do not converge....i have dbl vision, both eyes open....ptosis right eye.....frontalis muscles on the right are barely working....left eye doesnt go left.....i have a neuro ophthalmologist....been to an ophthalmologist.....optometrist, at the VA who really helped get me into a pair of prisms or i wouldnt be able to see a single vision on this screen.... i have in my records convergence insufficiency ... progressive external ophthalmoplegia of both eyes....diplopia....alternating exotropia....ptosis....to name a few .....and i am still at square one for knowing why this is happening.....
CPEO? (chronic progressive external ophthalmoplegia)
I love your videos you’re great
I saw dr. Golnick last year for diplopia who retired this year. He was thinking possible OMG but also a 4th cranial nerve. It went away after 3 months so we left it alone then came back again this year exactly 1 yr later and here 2 months into it it's starting to go away again. I'm baffled. Any ideas ? I'm guessing this isn't typical for MG? Thanks 👍BTW no other symptoms. testing is normal MRI and all blood work
I do suffer with diplopia.. been 1 month on steroid therapy they think its MG but mri and lumbar tap negative - rule out - then said its migraine