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Ophthalmoplegia (External Ophthalmoplegia)

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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: 606 relevant articles (27 outcomes, 16 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Muscle Weakness
2.	Ataxia (Dyssynergia)
3.	Ophthalmoplegia (External Ophthalmoplegia)
4.	Blepharoptosis (Ptosis, Eyelid)
5.	Miller Fisher Syndrome (Fisher Syndrome)

Experts

1.	Yuki, N: 10 articles (08/2006 - 05/2000)
2.	Yuki, Nobuhiro: 9 articles (11/2013 - 10/2002)
3.	Hirata, K: 7 articles (08/2006 - 05/2000)
4.	Koga, M: 5 articles (08/2006 - 05/2001)
5.	Mancuso, Michelangelo: 4 articles (11/2013 - 11/2004)
6.	Ronchi, Dario: 4 articles (05/2013 - 05/2010)
7.	Sciacco, Monica: 4 articles (05/2013 - 05/2010)
8.	Moggio, Maurizio: 4 articles (05/2013 - 05/2010)
9.	Fassone, Elisa: 4 articles (01/2013 - 05/2010)
10.	Jungbluth, Heinz: 4 articles (09/2011 - 01/2007)

Drugs and Biologics

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

1.	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. "
2.	Ryanodine Receptor Calcium Release Channel (Ryanodine Receptor)IBA 02/15/2015 - "Interestingly, patients with recessive, but not dominant, RYR1 mutations show a significant reduction in RyR protein in muscle biopsies as well as ophthalmoplegia. " 08/01/2007 - "Protein expression studies in nine cases suggested a correlation between specific mutations, RyR1 protein levels and resulting phenotype: in particular, whilst patients with dominant or recessive mutations associated with typical CCD phenotypes appeared to have normal RyR1 expression, individuals with more generalized weakness, multi-minicores and external ophthalmoplegia had a pronounced depletion of the RyR1 protein. " 07/01/2010 - "Three out of five patients had ophthalmoplegia, which may be the most specific clinical indication of mutations in RYR1. " 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."
3.	Thiamine (Aneurin)FDA Link 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." 06/01/1999 - "They presented with the clinical triad of WE (ophthalmoplegia, ataxia and disturbance of consciousness) and intravenous administration of thiamine led to complete elimination of these manifestations. " 01/01/2012 - "Treatment with moderate dose of thiamine for 3 months partly relieved ophthalmoplegia and confusion, but not Korsakoff syndrome. "
4.	SteroidsIBA 09/01/1998 - "The traumatic optic neuropathy that accompanies this fracture is distinct from the indirect type of optic nerve injury that may respond to steroids, and the ophthalmoplegia is distinct from the usual traumatic superior orbital fissure syndrome that resolves spontaneously. " 08/01/2006 - "The uveitis resolved with topical steroids; the interstitial keratitis resolved with a faint scar, and the internal ophthalmoplegia persisted. " 01/01/2015 - "The patient was treated with IVIG and intravenous steroids with mild resolution of external ophthalmoplegia. " 01/01/2012 - "We conclude that ophthalmoplegia secondary to Herpes Zoster Ophthalmicus responds favourably to intravenous acyclovir and steroids." 07/30/2008 - "Idiopathic Tolosa-Hunt syndrome (ITHS) is a very rare cause of painful ophthalmoplegia characterized by unilateral orbital pain, ipsilateral oculomotor paralysis and prompt response to steroids. "
5.	Levodopa (L Dopa)FDA LinkGeneric 06/01/1980 - "Both had intercurrent infection, and recovery from the ophthalmoplegia paralleled that from the infection, but the Parkinsonian features improved more gradually on increasing doses of levodopa." 10/01/2002 - "Clinical features suggesting a diagnosis of progressive supranuclear palsy (PSP) include early falls, axial rigidity, vertical supranuclear ophthalmoplegia, and levodopa unresponsiveness. " 01/01/2014 - "An 85-year old male with levodopa-responsive parkinsonism followed by dementia and supranuclear ophthalmoplegia caused by alzheimer-type pathology without Lewy bodies." 01/01/2012 - "A 75-year-old man developed l-dopa non-responsive parkinsonism, supranuclear ophthalmoplegia, neck dorsiflexion, and dementia. " 11/15/2007 - "Among 749 patients archived at the QSBB, only 7 fulfilled proposed diagnostic criteria of: gradual onset of freezing of gait or speech; absent limb rigidity and tremor; no sustained response to levodopa; and no dementia or ophthalmoplegia in the first 5 years of disease. "
6.	Intravenous Immunoglobulins (IVIG)FDA Link 12/01/2005 - "Treatment with IVIg resolved the acute ophthalmoplegia, but there was no notable improvement in the AMSAN and bulbar palsy despite repeated. " 04/03/2007 - "IVIg slightly hastened the amelioration of ophthalmoplegia and ataxia, but the times of the disappearances of those symptoms were similar among three groups. " 01/01/2015 - "The patient was treated with IVIG and intravenous steroids with mild resolution of external ophthalmoplegia. " 01/01/2013 - "We describe a young female with bilateral ptosis without ophthalmoplegia as the initial presentation of Guillain-Barré ptosis in an anti-GQ1b IgG antibody negative patient with a favorable outcome to intravenous immunoglobulins. " 08/01/2011 - " report a patient with isolated acute ophthalmoplegia with high titer of anti-GQ1b IgG antibody activity in the acute phase in whom treatment with intravenous immunoglobulin (IVIg) led to the clinical recovery and the decrease in antibody titer."
7.	Immunoglobulins (Immunoglobulin)IBA 11/01/2011 - "Canomad presenting without ophthalmoplegia and responding to intravenous immunoglobulin." 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. " 01/01/2012 - "One week after treatment with intravenous immunoglobulin, his ophthalmoplegia, blepharoptosis, and ataxic gait had gradually improved, and his deep tendon reflexes returned. " 01/01/2010 - "Acute bilateral ophthalmoparesis with pupilary areflexical mydriasis in miller-fisher syndrome treated with intravenous immunoglobulin." 01/01/1989 - "[Oculomotor paralysis and peripheral neuropathy caused by IgM kappa monoclonal immunoglobulin. "
8.	Anti-Bacterial Agents (Antibiotics)IBA 09/01/1950 - "[Extrinsic oculomotor paralysis caused by chemotherapy and antibiotics]." 07/01/2013 - "Gradenigo syndrome describes extension of a middle ear infection to the petrous apex, with trigeminal pain and ophthalmoplegia, typically responsive to antibiotics and often surgical drainage. " 12/15/2007 - "Orbital cellulitis is a severe infection presenting with proptosis and ophthalmoplegia; it requires hospitalization and intravenous antibiotics to prevent vision loss. " 08/01/1981 - "A tentative diagnosis of Tolosa-Hunt syndrome was made after an unproductive search for a cause for this woman's painful ophthalmoplegia and unsuccessful treatment of ophthalmoplegia with antibiotics or diet therapy for mild hyperglycemia. " 10/01/2006 - "Corneal epithelial defect, corneal edema, secondary bacterial keratitis, heterochromia iridis, and internal ophthalmoplegia were identified The corneal edema markedly improved 3 days after removing the retained bee stingers and treatment by topical antibiotics and steroids. "
9.	Acyclovir (Aciclovir)FDA LinkGeneric 01/01/2012 - "The internal ophthalmoplegia showed a potential mild improvement with oral acyclovir. " 01/01/2010 - "Ten days after stopping oral aciclovir, she presented with periorbital pain, visual loss, ptosis and complete ophthalmoplegia. " 02/01/2011 - "Despite antiviral therapy (acyclovir) for herpes zoster, ophthalmoplegia, keratitis, and post-herpetic neuralgia (PHN) developed. " 07/01/2004 - "Treatment with acyclovir and cortisone resulted in a rapid improvement of the ophthalmoplegia. " 01/01/2012 - "We conclude that ophthalmoplegia secondary to Herpes Zoster Ophthalmicus responds favourably to intravenous acyclovir and steroids."
10.	AcetylcholinesteraseIBA 08/01/2012 - "We describe a child with early-onset ptosis, complete ophthalmoplegia, facial and proximal muscle weakness, easy fatigability, a decremental electromyographic response, and a repetitive compound muscle action potential not improved by anti-acetylcholinesterase medication. " 09/01/2006 - "Six weeks later he developed worsening of external ophthalmoparesis with ptosis, responding to acetylcholinesterase inhibitor, confirming myasthenia gravis." 03/01/1992 - "We studied 4 siblings (3 men and 1 woman), ages 22 to 43 years, with congenital ptosis, external ophthalmoplegia, proximal muscle weakness and fatigability unresponsive to acetylcholinesterase (AChE) inhibitors. " 07/01/2014 - "Congenital myasthenic syndromes with end-plate acetylcholinesterase deficiency are rare autosomal recessive disorders characterized by onset of the disease in early childhood, general weakness exacerbated by exertion, ophthalmoplegia, and refractoriness to anticholinesterase drugs. " 03/01/2003 - "Congenital myasthenic syndromes with endplate acetylcholinesterase deficiency are very rare autosomal recessive diseases, characterized by onset of the disease in childhood, general weakness increased by exertion, ophthalmoplegia and refractoriness to anticholinesterase drugs. "

Therapies and Procedures

1.	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. " 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." 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. " 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)"
2.	Drug Therapy (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." 12/01/1981 - "Resolution of the ophthalmoplegia and the decrease in abnormally high levels of cerebrospinal fluid myelin basic protein after discontinuation of intrathecal medication suggested demyelination from chemotherapy and irradiation."
3.	Immunotherapy 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. " 02/22/2000 - "The authors describe three patients with chronic ophthalmoplegia in the presence of persistently high titers of immunoglobulin G anti-GQ1b antibody detected in an ELISA, one of whom improved with immunotherapy. "
4.	Meridians (Jing Luo) 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." 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]."
5.	Anesthesia 04/01/1995 - "Ophthalmoplegia and facial anesthesia improved in most patients, but none regained any vision in the affected eye. " 01/01/1991 - "When associated with ophthalmoplegia or corneal anesthesia, neurogenic ptosis requires a watch and wait policy." 03/01/1986 - "She was slow to awaken from anesthesia and was later noted to have a total external ophthalmoplegia. " 01/01/1981 - "[Anesthesia and "ophthalmoplegia plus"]." 03/01/2010 - "The syndrome is characterized by ophthalmoplegia, ptosis, proptosis of eye, dilation and fixation of the pupil, and anesthesia of the upper eyelid and forehead. "