The WBC count, serum CRP and ESR levels, proptosis on examination, ophthalmoplegia
, decreased VA, or abnormal pupillary reflex, conjunctival discharge and/or collection or inflammation in the orbital region on radiological imaging are indicated as signs of preseptal and orbital cellulitis (8-10).
Presentation Number of Patients Percentage Quadriparesis 36 90% Paraplegia 2 5% Respiratory Distress 12 30% B/L Facial Palsy 3 7.5% Bulbar Palsy 4 10% Neck Muscle Weakness 6 15% Sensory Disturbance 13 32.5% Ophthalmoplegia
3 7.5% Autonomic Dysfunction 12 30% Cerebrospinal fluid analysis was done for all the patients.
Clinical reasoning: A 44-year-old woman with rapidly progressive weakness and ophthalmoplegia
Conclusions: Noninvasive genetic screening is recommended for mtDNA mutations in MT-NDs and MT-ATP6 genes in patients with ophthalmoplegia
, muscle weakness, ataxia, and respiratory disorder.
The clinical triad of mental status change, ophthalmoplegia
, and gait ataxia is present in as few as 10% of cases.
Congenital Fibrosis of the Extraocular Muscles (CFEOM) is characterized by congenital non-progressive ophthalmoplegia
with or without ptosis affecting part or all of the oculomotor and/or the trochlear nucleus with its related nucleus and nerve (1).
On performing an examination, he had proptosis, periorbital puffiness, dilated episcleral vessels, sluggish pupillary reflex, external ophthalmoplegia
, and diminished vision.
(25) Hypogonadism has been found in mitochondrial encephalopathy, lactic acidosis, stroke-like episodes, chronic progressive external ophthalmoplegia
, mitochondrial neuro gastro intestinal encephalopathy, Kearns-Sayre syndrome, and several non-specific MIDs.
(8) There are a few case presentations in the literature reporting total ophthalmoplegia
, optic nerve involvement, ptosis, Vogt-Koyanagi-Harada, and uveitis as ocular findings of GBS.
Moreover, 60 min after admission, he developed ptosis, external ophthalmoplegia
, and poor gag reflex with difficulty in speech as well as swallowing, areflexia, and diminished strength in all four limbs as evident on neurological examination.
There was proptosis of the right eye of 1 cm with ophthalmoplegia
The presence of clinical features such as acute onset swelling, orbital protrusion, ophthalmoplegia
, and nasal purulent discharge is suggestive of the diagnosis of orbital abscess.