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Biomedical subjects

W W Bixenman

Publications and source records attributed to W W Bixenman.

14 recordsLinked to original sources
PubMed1988

Multiple sclerosis, euthyroid restrictive Grave's ophthalmopathy, and myasthenia gravis. A case report.

A 53-year-old physician with a 13-year history of multiple sclerosis presented with the subacute onset of an atypical, restrictive, euthyroid Grave's ophthalmopathy. The hypotropia and monocular upgaze restriction responded to a course of systemic and local steroids. Three months later, the patient developed ocular and systemic features of myasthenia gravis. This is the second reported case of coincident multiple sclerosis, myasthenia gravis, and thyroid-related disease complex.

Blepharoptosis↗
PubMed1983

Congenital hereditary downbeat nystagmus.

This report describes an 8-year-old boy with congenital hereditary downbeat nystagmus, the youngest person with downbeat nystagmus in the literature to date and the first to have an apparently congenital form. He had tended to keep his chin down since birth and had had difficulty reading since starting to attend school. His 28-year-old mother manifested a subclinical combined rotatory-downbeat nystagmus only in oblique downward gaze. Neither the child nor the mother demonstrated evidence of spinocerebellar degeneration. Homologous base-up prisms incorporated into glasses eliminated his chin-down head posture, improved his vision in primary position and "cured" his so-called learning disability.

Adult↗
PubMed1982

Apparent foveal displacement in normal subjects and in cyclotropia.

The average location of the fovea in relation to the optic nerve head was determined on fixation photographs from both eyes of 50 non-strabismic subjects. It was found to be 0.3 disc diameters below a horizontal line extended through the geometric center of the optic disc. The range of interocular and inter-individual variations from this position has been described. With the availability of this information, ophthalmoscopy and fundus photography have become useful ancillary tools in the diagnosis of cyclodeviations.

Adolescent↗
PubMed1982

Atypical clinical presentation of oculomotor (III) nerve palsy.

The atypical clinical presentations of three patients with an oculomotor (III) nerve palsy are outlined. The first patient is a 49-year-old with a painful, pupil-sparing ophthalmoplegia of sudden onset due to a pituitary adenoma which had eroded into the cavernous sinus. The second patient is a 7-year-old with a traumatic III nerve palsy who despite full recovery of her oculomotility, has been symptomatic due to a permanent internal ophthalmoplegia. The third patient is an 8-year-old who has undergone prolonged optometric therapy for an "atypical esotropia," but in fact has a congenital III nerve palsy with oculomotor synkinesis and deep amblyopia.

Adenoma↗
PubMed1981

Diagnosis of superior oblique palsy.

Superior oblique muscle palsy is not only the most frequent cause of acquired vertical strabismus, anomalous head posturing and torsional diplopia, but also the most common isolated oculomotor paralysis seen in everyday ophthalmic practice. Adults typically present to the ophthalmologist with asthenopic symptoms of long duration, while children present with objective clinical signs. An understanding of the available subjective and objective examination techniques will enable the clinician to diagnose the presence of this cyclovertical muscle paralysis. There are clues from the examination that suggest a superior oblique palsy of long duration, which may save the patient a needless neurological workup and a 6-month wait before surgical options can be considered. There are also clues from the examination that suggest the presence of a "masked" bilateral superior oblique palsy. Most cases of previously diagnosed skew deviation, if examined closely, will actually turn out to be mild trochlear nerve pareses.

Adult↗
PubMed1977

Oculomotor disturbances associated with 5-fluorouracil chemotherapy.

Two patients treated with 5-fluorouracil (5-FU) for disseminated adenocarcinoma of the colon developed cerebellar dysfunction typical of 5-FU neurotoxicity. The neurotoxicity was associated with oculomotor disturbances expressed primarily as weakness of convergence and divergence. Detailed postmortem examination of one patient revealed no anatomical abnormalities of the central nervous system. The ocular motor disturbances are probably an expression of regional 5-FU neurotoxicity primarily affecting the brain stem.

Adenocarcinoma↗
PubMedDate not supplied

Vertical prisms. Why avoid them?

Vertical prisms are useful in the permanent or temporary alleviation of asthenopic symptoms arising from a vertical misalignment of the visual axes. A wide variety of both comitant and noncomitant hyperdeviations may be candidates for vertical prism use. Vertical prism strength is seldom difficult to compute and when properly employed, vertical prisms do not lead to unsightly spectacles.

Aged↗
PubMedDate not supplied

Atypical presentation of restrictive orbital myositis.

The histories of two patients with restrictive ophthalmopathy are reported in whom the initial diagnosis was delayed primarily due to the relatively acute onset. This form of onset of dysthyroid orbital myositis is unique in our experience and demonstrates the importance of realizing that the restrictive ocular motility disorder of Graves' ophthalmopathy may occur abruptly. By such recognition, one may proceed with the appropriate laboratory investigation and spare the patient invasive procedures.

Aged↗
PubMedDate not supplied

Benign recurrent VI nerve palsy in childhood.

The case of a child with six documented episodes of benign recurrent unilateral VI nerve palsy between the ages of 2 1/2 months and 3 years is presented. Despite the recognized self-limiting course of this disorder, its possible evolution into a comitant esotropia makes close follow-up mandatory. The practical aspects of management including maintenance occlusion therapy are stressed as well as the need for prompt surgical intervention once the acquired stabismus has become stabilized. The etiology of benign VI nerve palsy of childhood may have the same immunological basis as other cases of para-infectious neuropathy. This isolated postinfective cranial mononeuropathy easily blends into the continuum of neurological involvement seen with the Landry-Guillian-Barre syndrome. With recovery from the initial episode, the abducens nerve may have become predisposed to recurrent inflammatory episodes and recurrent loss of function. Most often these recurrences are triggered by febrile illnesses of childhood.

Abducens Nerve↗
PubMedDate not supplied

Binocular diplopia associated with retinal wrinkling.

Four patients with retinal wrinkling and epiretinal membrane formation presented with a unique clinical syndrome consisting of comitant, small angle hyperdeviations with intractable vertical diplopia, and unstable single vision with a failure to respond to conventional prism therapy. The pathophysiology underlying this presentation appears to be the establishment of a rivalry between central and peripheral fusional mechanisms due to mechanical macular distortion.

Adult↗
PubMedDate not supplied

Acquired esotropia as initial manifestation of Arnold-Chiari malformation.

A 13-year-old patient originally presented with a divergence palsy and gaze-evoked nystagmus. Over a short period of time, the esotropia became increasingly comitant and was successfully treated with strabismus surgery. Three years later, she developed downbeat nystagmus. An Arnold-Chiari Malformation could only be demonstrated using nuclear magnetic resonance imaging (MRI). Subsequent neurosurgical decompression resulted in resolution of the downbeat nystagmus with maintenance of single binocularity.

Adolescent↗