0
Article |

Disorders of Ocular Motility Following Head Trauma

Frederick E. Lepore, MD
Arch Neurol. 1995;52(9):924-926. doi:10.1001/archneur.1995.00540330106022.
Text Size: A A A
Published online

Objective:  To determine the types and frequency of symptomatic ocular motility disturbances following head trauma and their association with severity of trauma.

Design:  Retrospective study of patients with (1) diplopia unless visual loss is present, (2) heterotropia for far or near targets, and (3) prior head injury.

Setting:  Office and in-hospital consulting practice of a university neuro-ophthalmologist.

Subjects:  Sixty patients with posttraumatic ophthalmoplegia.

Main Outcome Measures:  Paralytic and nonparalytic heterotropias were quantitated in prism diopters or percentage limitation of ductions. Convergence insufficiency was assessed by determining the near point of convergence.

Results:  Fifty-one patients had nuclear or infranuclear findings, ie, trochlear palsies (n=20), oculomotor palsies (n=17), abducens palsies (n=7), combined palsies (n=5), and restrictive ophthalmopathy (n=2). Nine patients had supranuclear dysfunction, including seven patients with convergence insufficiency. Bilateral ocular motor palsies and combined palsies were significantly (by means of X2 test) associated with head trauma of severity sufficient to cause corticospinal tract dysfunction. Individual or combined ocular motor palsies were not significantly (by means of X2 test) associated with intracranial hemorrhage and/or skull fracture or loss of consciousness.

Conclusions:  Trochlear palsy was the most common nuclear or infranuclear basis for traumatic diplopia, and convergence insufficiency was the most common supra-nuclear cause of double vision. Head trauma distinguished by upper motor—neuron signs was correlated with specific subsets of disordered ocular motility.

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();