Ophthalmoplegia (External Ophthalmoplegia)

Paralysis of one or more of the ocular muscles due to disorders of the eye muscles, neuromuscular junction, supporting soft tissue, tendons, or innervation to the muscles.

Also Known As:

External Ophthalmoplegia; Ophthalmoparesis; Internal Ophthalmoplegia; External Ophthalmoplegias; Internal Ophthalmoplegias; Ophthalmopareses; Ophthalmoplegia, External; Ophthalmoplegia, Internal; Ophthalmoplegias; Ophthalmoplegias, External; Ophthalmoplegias, Internal; Paralysis, Oculomotor; Oculomotor Paralysis

Networked: 867 relevant articles (48 outcomes, 20 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Muscle Weakness
2.	Ataxia (Dyssynergia)
3.	Guillain-Barre Syndrome
4.	Paralysis (Palsy)
5.	Headache (Headaches)

Experts

1.	Yuki, N: 11 articles (02/2016 - 05/2000)
2.	Yuki, Nobuhiro: 10 articles (11/2013 - 10/2002)
3.	Hirata, K: 7 articles (08/2006 - 05/2000)
4.	Taylor, Robert W: 6 articles (01/2022 - 07/2005)
5.	Koga, M: 5 articles (08/2006 - 05/2001)
6.	Kuwahara, Motoi: 4 articles (01/2022 - 01/2012)
7.	Treves, Susan: 4 articles (01/2020 - 01/2007)
8.	Lee, Andrew G: 4 articles (12/2019 - 01/2007)
9.	Kusunoki, Susumu: 4 articles (11/2018 - 01/2003)
10.	Mancuso, Michelangelo: 4 articles (11/2013 - 11/2004)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Ophthalmoplegia:

1.	Intravenous Immunoglobulins (IVIG)FDA Link 07/21/2018 - "A second IVIg course was given and the patient was weaned off ventilation on day 41 and transferred to rehabilitation on day 57 with partial resolution of the ophthalmoplegia and limited recovery of muscle strength. " 11/01/2011 - "Canomad presenting without ophthalmoplegia and responding to intravenous immunoglobulin." 10/01/1999 - "Marked improvement of ophthalmoplegia followed high dose intravenous immunoglobulin therapy. " 12/01/2005 - "Treatment with IVIg resolved the acute ophthalmoplegia, but there was no notable improvement in the AMSAN and bulbar palsy despite repeated. " 09/01/2008 - "After intravenous immunoglobulin treatments, all neurological symptoms including optic neuropathy and external ophthalmoplegia disappered except for pupillary dilatation associated with light-near dissociation. "
2.	Adrenal Cortex Hormones (Corticosteroids)IBA 01/16/2011 - "To date the scientific literature does not include any reports of this disease manifesting as bouts of recurrent painful ophthalmoparesis which responds to corticoids, as happened in the case of our patient." 07/01/2001 - "Corticosteroids are usually necessary for adequate improvement of ophthalmoplegia or ptosis. " 01/01/1990 - "A 67-year old woman presented with isolated and bilateral external ophthalmoplegia of the myasthenic type following a subacute course and resistant to anticholesterinases and corticosteroids. " 05/01/2017 - "External ophthalmoparesis improved in seven cases, five cases under no treatment and two under systemic corticosteroid therapy. " 05/01/2021 - "After 2 tapering cycles of oral corticosteroid treatment, her photophobia resolved, and ophthalmoplegia significantly improved. "
3.	Immunoglobulin G (IgG)IBA 01/01/2012 - "The antiganglioside anti-GQ1b IgG antibody has a role in the pathogenesis of the syndrome, especially of ophthalmoplegia. " 06/01/2006 - "Four of them showed ophthalmoplegia and had anti-GQ1b IgG antibody. " 06/01/2005 - "IgG anti-GQ1b antibody might contribute not only oropharyngeal weakness but also internal ophthalmoplegia in this patient." 06/01/2003 - "Acute ophthalmoparesis in a child with anti-GQ1 b IgG antibody." 06/01/2003 - "The anti-GQ1b/GT1a IgG titer, the extent of ophthalmoplegia and the extent of MFI were significantly correlated. "
4.	SteroidsIBA 01/01/2021 - "Our meta-analysis suggests that extended steroid taper may aid the recovery of ophthalmoplegia in the setting of HZO and should be investigated further in the future." 01/01/2020 - "After a 4-week gradual steroid taper his ophthalmoplegia resolved. " 08/01/2006 - "The patient had a remarkable complete resolution of his ophthalmoplegia after four weeks of steroid treatment, with repeat MR imaging showing resolution of the initial changes." 10/01/2001 - "Ophthalmoplegia resolved spontaneously in 1 child and after steroid treatment in the other. " 06/01/1985 - "Steroid-responsive ophthalmoplegia in a child. "
5.	Thiamine (Aneurin)FDA Link 12/01/2021 - "The ophthalmoplegia, vestibular, and auditory expeditious improvement with intravenous thiamine usually confirms the diagnosis; serum levels generally provide additional diagnostic certainty. " 01/01/2019 - "Two months after the onset of gastrointestinal symptoms, external ophthalmoplegia appeared, and, therefore, intravenous thiamine was given. " 01/01/2007 - "The patient was admitted, and a single dose of IV thiamine reversed the ophthalmoplegia and vision loss within 24 hours. " 11/01/2004 - "The ophthalmoplegia resolved with thiamine administration; however, his memory did not improve." 09/01/2005 - "Acute ophthalmoplegia and nystagmus in infants fed a thiamine-deficient formula: an epidemic of Wernicke encephalopathy."
6.	Anti-Bacterial Agents (Antibiotics)IBA 09/01/2022 - "Despite systemic antibiotic and antiplatelet therapy, he developed progressively worsening left-sided ophthalmoplegia and vision decline. " 01/01/2022 - "A 72-year-old male patient was referred to our outpatient clinic with a painful left eye protrusion accompanied by marked conjunctival chemosis and external ophthalmoplegia being progressed despite topical and oral antibiotic therapy. " 09/01/1950 - "[Extrinsic oculomotor paralysis caused by chemotherapy and antibiotics]." 06/01/2022 - "One day after initiation of oral antibiotic and non-steroidal anti-inflammatory therapy, he developed worsening of the orbital inflammation and partial ophthalmoplegia. " 06/01/1984 - "The authors believe that carotid arteriography is obligatory in cases of cavernous sinus thrombophlebitis in which ophthalmoplegia persists despite adequate antibiotic therapy."
7.	Edrophonium (Tensilon)FDA LinkGeneric 01/01/2022 - "However, he was diagnosed with CMS at age 4 years when his ptosis and ophthalmoplegia were found to be improved by edrophonium chloride and repetitive nerve stimulation showed attenuation of compound muscle action potentials. " 06/22/2019 - "Edrophonium chloride improved the patient's bilateral ptosis, but not her ophthalmoplegia. " 10/01/1990 - "The tensilon stimulation test resulted in resolution of the ptosis and partial improvement of the ophthalmoplegia. " 04/01/1999 - "In a myasthenia gravis patient with profound ophthalmoplegia who was given edrophonium during forward fixation or horizontal/vertical saccades, horizontal macrosaccadic oscillations occurred that were conjugate, 2 to 3 Hz, and of peak-to-peak amplitude up to 50 degrees. " 09/01/1989 - "Diagnosis of myasthenia gravis had been made on the clinical findings including ptosis and external ophthalmoplegia, diurnal fluctuation of symptoms, and equivocal positive Tensilon test. "
8.	Proteins (Proteins, Gene)FDA Link 09/16/2022 - "The patient had ophthalmoplegia, ataxia, weak force, and protein-cell separation in cerebrospinal fluid during the development of the disease. " 08/01/1988 - "We describe an 11-year-old boy with external ophthalmoplegia, pigment retinopathy, hearing loss, elevated spinal protein and ragged-red fibers on muscle biopsy. " 11/01/1985 - "A 7-year-old girl had external ophthalmoplegia, limb weakness, short stature, hearing loss, pigmentary degeneration of the retina, and increased CSF protein content. " 01/01/1984 - "The authors describe a 43-year-old man with ophthalmoplegia, ataxia and areflexia and with 0.42 g/l of protein in the cerebrospinal fluid. " 09/01/1978 - "Clinical symptoms consisted of complete external ophthalmoplegia, ptosis, short stature, atrophy and weakness of skeletal muscles, and elevated csf protein. "
9.	Ryanodine Receptor Calcium Release Channel (Ryanodine Receptor)IBA 07/01/2010 - "Three out of five patients had ophthalmoplegia, which may be the most specific clinical indication of mutations in RYR1. " 01/01/2020 - "Mutations in the RYR1 gene are the most common cause of human congenital myopathies, and patients with recessive mutations are severely affected and often display ptosis and/or ophthalmoplegia. " 12/01/2013 - "Total ophthalmoplegia can result from ryanodine receptor 1 (RYR1) mutations without overt associated skeletal myopathy. " 12/01/2013 - "RYR1 mutations as a cause of ophthalmoplegia, facial weakness, and malignant hyperthermia." 09/01/2011 - "Our results suggest that muscle MRI is a powerful predictor of RYR1 involvement in patients with a congenital myopathy, especially if they carry a dominant mutation or recessive mutations without ophthalmoparesis."
10.	Valproic Acid (Depakote)FDA LinkGeneric 04/07/2021 - "A trial with lamotrigine and sodium valproate led to the complete improvement in ophthalmoplegia within 2 weeks. "

Therapies and Procedures

1.	Therapeutics 04/01/1996 - "The evaluation method for the severity of external ophthalmoplegia that we used in the present study is useful for assessing the effect of therapy on Fisher's syndrome." 01/01/2022 - "In the immediate postoperative period, the patients exhibited oculomotor paralysis and was discharged with hormonal replacement therapy three weeks after operation. " 10/01/2018 - "Myasthenic ophthalmoparesis: Time To resolution after initiating immune therapies." 02/01/2017 - "Time to therapy from developing a visual disturbance was longer than time to therapy from developing ophthalmoplegia (P = 0.001). " 12/01/2012 - "External ophthalmoplegia in human immunodeficiency virus-infected patients receiving antiretroviral therapy."
2.	Drug Therapy (Chemotherapy) 08/01/2017 - "Her ophthalmoplegia improved from her first cycle of systemic and intrathecal chemotherapy. " 11/01/2007 - "His ophthalmoplegia improved from his first cycle of systemic and intrathecal chemotherapy, his thigh mass effusion spontaneously resolved, and his laboratory tests also showed improvement. " 08/01/2004 - "Whilst the patient was receiving chemotherapy, a second relapse occurred responsible for ophthalmoplegia and loss of vision, with involvement of the left orbital apex, cavernous sinus and temporal lobe. " 08/01/1998 - "On referral to the regional orbital unit a mild left external ophthalmoplegia was noted and, in view of previous right mastectomy and chemotherapy 3 years earlier, the left optic nerve was biopsied simultaneously with left enucleation of her painful eye. " 09/01/2001 - "Although hemorrhagic oculomotor paralysis is a very rare complication, reports of its occurrence will likely increase with improved survival times of leukemia patients due to advances in chemotherapy."
3.	Plasmapheresis 03/01/1995 - "We treated her with plasmapheresis after which she showed rapid clinical recovery, although the ophthalmoplegia improved slightly later. " 10/01/2001 - "We performed plasmapheresis four times, which improved her level of consciousness, hyperesthesia, external ophthalmoplegia and muscle weakness, and led to the normalization of brain and spinal cord MRI. " 03/01/1990 - "The existence of ophthalmologic signs (retinitis pigmentosa or progressive ophthalmoplegia externa) associated with a myocardiopathy must systematically lead to a search for Refsum's disease, this diagnosis having fundamental therapeutic implications (died, even plasmapheresis).(ABSTRACT TRUNCATED AT 250 WORDS)" 12/01/2002 - "The analysis of 4 MFS cases revealed that we had performed plasmapheresis or additional immunotherapy to each of 4 patients, and their symptoms resolved for up to 50 days after the onset (ataxia improved 20-35 days and ophthalmoplegia for 25-50 days) except for 1 patient, and that Guillain-Barré syndrome had been diagnosed in 1 patient who had developed profound muscle weakness. " 01/01/2003 - "Plasmapheresis or intravenous immunoglobulin therapy may be warranted for Miller Fisher syndrome and Bickerstaff's brainstem encephalitis, as well as Guillain-Barré syndrome with ophthalmoplegia."
4.	Immunotherapy 10/01/2021 - "Myasthenic ophthalmoparesis is bilateral and heterogeneous and partly responds to treatment with immunotherapy. " 10/01/2018 - "One-third of cases with myasthenic ophthalmoparesis resolved within 3 months of immunotherapy, particularly in response to more aggressive immunotherapy. " 10/01/2018 - "With immunotherapy, the median time to resolution of ophthalmoparesis was 7 months, and 37% of cases resolved within 3 months. " 07/14/2021 - "We report a case of anti-GAD ataxia presenting initially with isolated ophthalmoplegia and showing complete resolution after immunotherapy. " 10/01/2018 - "We observed patients with myasthenia gravis during their first year of immunotherapy, documenting ophthalmoplegia scores and drug doses. "
5.	Meridians (Jing Luo) 02/01/2010 - "The authors compared and analyzed the correlated meridians in Internal Classic and Study on the Eight Extra-Channels and Vessels by clinical observation on acupuncture for treatment of oculomotor paralysis and reorganization research on ancient related literature, and course of meridians and collaterals, manifestations of disease and function were used as indexes. " 02/01/2010 - "[Study on acupuncture for treatment of oculomotor paralysis according to syndrome differentiation of meridians]." 02/01/2010 - "The results indicate that it is important to regulate the Qiao Meridian function for acupuncture treatment of oculomotor paralysis; the method of the twelve regular meridians and the eight extra-meridians is different for treatment of this disease, for the twelve regular meridians treating the superficiality and the eight extra-meridians treating the origin, and the combinativue use of the two methods can display the TCM theory thought and the characteristic of simultaneous treatment of principal and subordinate symptoms; there is closely relation between musculature diseases and pathological change of oculomotor paralysis and it is helpful in perfecting therapeutic principles and research methods."