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Corneal Reflex

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481. Rare Disease Patient Registry: Coordination of Rare Diseases at Sanford

Epilepsy and/or Ataxia With Myoclonus as a Major Feature Spectrin-associated Autosomal Recessive Cerebellar Ataxia Spasticity-ataxia-gait Anomalies Syndrome Spastic Ataxia With Congenital Miosis Spastic Ataxia - Corneal Dystrophy Spastic Ataxia Rare Hereditary Ataxia Rare Ataxia Recessive Mitochondrial Ataxia Syndrome Progressive Epilepsy and/or Ataxia With Myoclonus as a Major Feature Posterior Column Ataxia - Retinitis Pigmentosa Post-Stroke Ataxia Post-Head Injury Ataxia Post Vaccination Ataxia (...) Episodic Ataxia Type 3 Episodic Ataxia Type 1 Epilepsy and/or Ataxia With Myoclonus as Major Feature Early-onset Spastic Ataxia-neuropathy Syndrome Early-onset Progressive Neurodegeneration - Blindness - Ataxia - Spasticity Early-onset Cerebellar Ataxia With Retained Tendon Reflexes Early-onset Ataxia With Dementia Childhood-onset Autosomal Recessive Slowly Progressive Spinocerebellar Ataxia Dilated Cardiomyopathy With Ataxia Cataract - Ataxia - Deafness Cerebellar Ataxia, Cayman Type Cerebellar Ataxia

2013 Clinical Trials

482. Orbital apex tumour caused by chronic lymphocytic leukaemia: an unlikely suspect (PubMed)

Orbital apex tumour caused by chronic lymphocytic leukaemia: an unlikely suspect An 88-year-old woman with a background of chronic lymphocytic leukaemia (CLL) and presented with unilateral ptosis and dull facial pains for 1 month. Examination revealed a complete right-sided ptosis and pupillary dilation. Vision in her right eye was limited to light perception. She had total external ophthalmoplegia. Her corneal reflex was not present in her right eye and she had lost sensation on the right side

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2013 BMJ case reports

483. Anesthetic Effects of a Mixture of Medetomidine, Midazolam and Butorphanol in Two Strains of Mice (PubMed)

mg/kg b.w. midazoram (Mid.), and 5.0 mg/kg b.w. butorphanol (But.) produced an anesthetic duration of around 40 min in outbred ICR mice. However, the anesthetic effect of the mixture for inbred mice strains remains unknown. Therefore, we examined anesthetic effects of the mixture of Med., Mid., and But. in the BALB/c and C57BL/6J strains. After intraperitoneal injection into mice, right front paw, left hind paw, and tail pinch reflexes as well as corneal and righting reflexes were observed. Every (...) 5 min, we scored each reflex category as 0 for reaction or 1 for no reaction. As long as the total score was at least 4 out of 5, we considered the mixture as putting a mouse in a surgical anesthetic state. The mixture produced an anesthetic duration of more than 45 min in both strains of mice. These results indicate that the mixture of Med., Mid., and But. can be a useful and effective anesthesia for the BALB/c and C57BL/6J strains of inbred mice as well as outbred ICR mice.

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2013 Experimental Animals

484. Intramuscular administration of alfaxalone in red-eared sliders (Trachemys scripta elegans)--effects of dose and body temperature. (PubMed)

minutes. Endotracheal intubation was successful in 80%, 100%, 0% and 30% of turtles, respectively. At 35°C, all animals retained nociceptive sensation in the front limbs, hind limbs and vent, whereas at 20°C a few turtles lost peripheral nociceptive sensation. Corneal and tap reflexes were retained in all trials. Mean heart rates were 30±2 and 66±4 beats minute(-1) at 20 and 35°C, respectively.Alfaxalone administered i.m. in red-eared sliders provided smooth, rapid induction and uneventful recovery (...) respectively. Time to maximal effect and plateau and recovery periods were recorded. Skeletal muscle tone, presence of various reflexes, response to noxious stimuli, and heart rate were assessed.Results are given for protocols 10 mg kg(-1) 20°C; 20 mg kg(-1) 20°C; 10 mg kg(-1) 35°C and 20 mg kg(-1) 35°C, respectively: mean time (±SD) to maximal effect was 16±8, 19±6, 5±2 and 7±5 minutes; duration of the plateau phase was 13±12, 28±13, 8±5 and 8±5 minutes and recovery time was 76±20, 126±17, 28±9 and 41±20

2013 Veterinary anaesthesia and analgesia Controlled trial quality: uncertain

485. Prognosis of coma after therapeutic hypothermia: A prospective cohort study. (PubMed)

with hypothermia (32-34°C). False-positive rates (FPRs 1 - specificity) with their 95% confidence intervals (CIs) were calculated for pupillary light responses, corneal reflexes, and motor scores 72 hours after CPR; NSE levels at admission, 12 hours after reaching target temperature, and 36 hours and 48 hours after collapse; and SEPs during hypothermia and after rewarming. The primary outcome was poor outcome, defined as death, vegetative state, or severe disability (Glasgow Outcome Scale 1-3) after 6 (...) months.Of 391 patients included, 53% had a poor outcome. Absent pupillary light responses (FPR 1; 95% CI, 0-7) or absent corneal reflexes (FPR 4; 95% CI, 1-13) 72 hours after CPR, and absent SEPs during hypothermia (FPR 3; 95% CI, 1-7) and after rewarming (FPR 0; 95% CI, 0-18) were reliable predictors. Motor scores 72 hours after CPR (FPR 10; 95% CI, 6-16) and NSE levels were not.In patients with persisting coma after CPR and therapeutic hypothermia, use of motor score or NSE, as recommended in current

2012 Annals of Neurology

486. Primary bilateral silicone frontalis suspension for good levator function ptosis in oculopharyngeal muscular dystrophy. (PubMed)

performed by a single individual. The following data were collected: age; gender; pre-operative margin reflex distance (MRD), palpebral fissure height (PF), and LF; post-operative MRD, PF and lagophthalmos; follow-up; and complications.Mean age at surgery was 61.5 ± 5.8 years. Pre-operative measurements for MRD, PF and LF were -0.05 ± 0.82 mm (OD), -0.13 ± 0.91 mm (OS); 5.2 ± 1.2 mm (OD), 5.2 ± 1.3 mm (OS); 11.6 ± 1.3 mm (OD), and 11.7 ± 1.3 mm (OS), respectively. Post-operative measurements for MRD (...) and PF were 2.23 ± 0.97 mm (OD), 2.10 ± 1.09 mm (OS), 7.9 ± 1.4 mm (OD), and 7.7 ± 1.6 mm (OS), respectively (all p < 0.0001). The mean follow-up period was 22.8 ± 22.4 months. There was no sling (infection or extrusion) or ophthalmic (significant corneal compromise) complication after the surgery. Six patients (19%) underwent early (within 3 months) tightening of their slings for under correction. Three patients (10%) underwent late (> 39 months) tightening of their frontalis slings for recurrent

2012 British Journal of Ophthalmology

487. Comparative study of Gamma Knife surgery and percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis. (PubMed)

group (all due to sensory loss and paresthesia) and 66.7% in the PRGR group (mostly hypalgesia, with 2 patients having corneal reflex loss and 1 patient suffering from meningitis).Both GKS and PRGR are satisfactory strategies for treating MS-related TN. Gamma Knife surgery has a lower rate of sensory and overall morbidity than PRGR, but requires a delay before pain relief occurs. The authors propose that patients with extreme pain in need of fast relief should undergo PRGR. For other patients, both

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2012 Journal of Neurosurgery

488. Occult Intraocular Trauma: Evaluation of the Eye in an Austere Environment. (PubMed)

in an austere or hostile environment.A 25-year-old male U.S. Marine was fired upon at a Mexican Army checkpoint where he sustained glass shrapnel injuries, the most serious being to his right eye. He was taken from a detention facility to a Mexican hospital, where he was evaluated and given the diagnosis of corneal laceration. Twelve hours later, a U.S. Navy physician arrived to evaluate the patient; he was allowed limited access to the patient. His ophthalmologic examination revealed a closed corneal (...) laceration on the right eye, worse than 20/800 vision, absent red reflex, and obscured funduscopic examination. These findings made it impossible to rule out globe penetration. The patient was released 48 h later to a U.S. Naval Hospital, where intraocular foreign bodies were confirmed by imaging and he was taken to emergency surgery.This case illustrates that even under austere conditions, a focused history and evaluation can reveal the likelihood of occult intraocular foreign body, thereby triaging

2012 Journal of Emergency Medicine

489. A case of inaccurate prognostication after the ARCTIC protocol. (PubMed)

of poor outcome included lack of one or more brainstem reflexes (pupillary or corneal reflex), absence of motor response at 72 hours, myoclonus, status epilepticus, electroencephalogram with generalized suppression, and absent bilateral cortical N20 response to somatosensory-evoked potentials. However, several studies have found these indicators to be unreliable after hypothermia. This may be the result of sedatives, which can affect physical examination and electroencephalogram results, and delayed (...) was defibrillated twice, with return of spontaneous circulation, and cooled to 33°C for 24 hours. Neurologic exam on Day 6 revealed limited brainstem reflexes, and the intensive care unit team discussed with the patient's family that his prognosis for neurologic recovery was poor. Palliative care was consulted to participate in a goals-of-care meeting. Just prior to the meeting on Day 7, the patient awoke. He fully recovered and walked out of the hospital on Day 18. Prior to induced hypothermia, indicators

2012 Journal of pain and symptom management

490. Measurement of angle kappa and centration in refractive surgery. (PubMed)

).Determination of the treatment center is very important in refractive surgery. Moving the ablation center from the center of the entrance pupil to points near visual axis, such as the corneal light reflex (line of sight) or corneal vertex normal, results in less induction of higher order aberrations (including coma aberration) and either the same or better visual outcomes both in hyperopic and myopic eyes when compared to laser ablation centered on the entrance pupil. Decentration of multifocal IOLs can

2012 Current Opinion in Ophthalmology

491. A Study of 2-Iminobiotin in Neonates With Perinatal Asphyxia

concentration). t1/2 (terminal elimination half-life) CL (clearance) V (volume of distribution) Neurological status as assessed by full neurological examination [ Time Frame: at discharge from level III NICU on the average this will 7-14 days after birth. ] Full neurological examination includes: Prechtl state, Higher cortical functions, Pupillary reflexes right,Pupillary reflexes left, corneal reflex right, corneal reflex left, optokinetic reflexes, nystagmus, facial symmetry, tone, spontaneous movements (...) right, spontaneous movements left, tendon reflexes, ankle clonus right, ankle clonus left, sucking reflex, grasp reflex right, grasp reflex left, moro reflex right, moro reflex left, glabella reflex, snout reflex, palmomental reflex right, palmomental reflex left. Outcomes will be compared between arms aEEG. Time to normal aEEG [ Time Frame: Up to 72 hours after start treatment ] The time to normal aEEG will be determined for each subject. aEEG. Seizures (clinical and sub-clinical) [ Time Frame: 48

2012 Clinical Trials

492. Hyaluronic Acid Gels for Upper Lid Retraction in Active Stage Thyroid Eye Disease

. The precise pathophysiology of lid retraction is poorly understood, but a leading hypothesis is that it occurs due to scarring and fibrosis in the muscles that lift the eyelid. Currently, the definitive treatment for lid retraction is surgery, which can be used to lengthen the lid itself or remove inflamed tissue from behind the eye, thus causing the eye to bulge less. In cases when patients first present to their physician with corneal ulceration or compression of the optic nerve, surgery may (...) and lower eyelid retraction in TED. Hence, HAG may be for patients with active stage TED. It is also thought that if employed early in active phase disease, HAG may also help to decrease the severity of associated symptoms and reduce the need for surgery. The purpose of the current investigation is to define the clinical utility of HAG correction of upper eyelid in active TED in terms of anatomic (lid position), quantitative (corneal dry eye signs) and qualitative effects (symptom severity and thyroid

2012 Clinical Trials

493. The Role of Xerostomia in Burning Mouth Syndrome: Case

; thermal detection thresholds for cold and warm sensations; mechanical detection thresholds for touch, vibration and electrical perception; mechanical pain sensitivity including superficial and deep pain thresholds; electric pain threshold at the teeth. corneal reflex. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 38 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double (Participant

2012 Clinical Trials

494. Identification and Validation of Functional Biomarkers for Keratoconus

signs like retinoscopy scissors reflex, Munson sign, stromal thinning, Vogt's striae, and Fleischer's ring, but corneal topography is the most useful method in the diagnosis of keratoconus, especially in the absence of clinical signs. Several devices are currently available for detecting early keratoconus by measuring anterior and posterior corneal topography and elevation(Mihaltz et al. 2009; Ishii et al. 2012). Corneal topographic and tomographic techniques which generate color-coded maps (...) . 2002). These indices have been shown to identify keratoconus with a high degree of sensitivity and specificity. The Orbscan II is a three-dimensional slit-scan topography system for analysis of the corneal surfaces and anterior chamber and has been used on all patients in the study. It uses calibrated video and a scanning slit beam to measure x, y, and z locations of several thousand points. These points are used to construct topographic maps(Rao et al. 2002). The Pentacam (Oculus Inc) is a corneal

2012 Clinical Trials

495. Brow ptosis: are we measuring the right thing? The impact of surgery and the correlation of objective and subjective measures with postoperative improvement in quality-of-life (PubMed)

eyelid position (ie, distance mm from corneal reflex to upper skin fold (FRD1), lowest brow hair to lower limbus (LLB), centre of lower lid to upper lid skin fold (LLF)) and number of points missing in 'superior' and 'superior plus elsewhere' Humphrey 120-point visual field, as well as a Quality-of-life and Visual Function questionnaire before and after brow lift surgery.The strongest correlation between pre-op functional index score and any pre-op objective measure was visual fields (r=-0.46, P

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2012 Eye

496. Eye Examination Signs of Chemical Dependency

: Abnormal Extraocular Movements Fails to hold gaze (PCP) - may occur Abnormal Convergence (unable to hold crossed eyes) s V. Exam: Abnormal Corneal Reflex (Decreased rate of blinking) (PCP) VI. Exam: Abnormal Retinal Exam Talc retinopathy (talc used to cut IV drugs) Peri- r vessels show white retractile spots VII. Exam: Corneal defects Keratopathy or s Associated with crack smoking VIII. Contributors Paul Rock, OD at Outer Banks Eye Care IX. Reference Images: Related links to external sites (from Bing

2015 FP Notebook

497. Bell's Palsy

MRI Identifies central causes (Schwannoma, , meningioma and ) MRI offers prognostic information based on nerve contrast enhancement Indications Suspected central cause (see Red Flags above) Persistent or progressive peripheral Facial Nerve Palsy lasting >2 months Facial twitching or spasm XV. Management: Loss of Blink Reflex Rewetting the eye Frequent use of preservative-free artificial tears (every 15 to 30 minutes) Refresh PM ointment six times daily Protective glasses with side pieces Use (...) :// ) Definition (MSH) A syndrome characterized by the acute onset of unilateral FACIAL PARALYSIS which progresses over a 2-5 day period. Weakness of the orbicularis oculi muscle and resulting incomplete eye closure may be associated with corneal injury. Pain behind the ear often precedes the onset of paralysis. This condition may be associated with HERPESVIRUS 1, HUMAN infection of the facial nerve. (Adams et al., Principles of Neurology, 6th ed, p1376) Concepts Disease or Syndrome ( T047 ) MSH

2015 FP Notebook

498. Brain death--think twice before labeling a patient. (PubMed)

Brain death--think twice before labeling a patient. Brain death is defined as the cessation of cerebral and brainstem function. A 12-year-old boy presented with alleged history of snake bite. He was brain dead with Glasgow Coma Score of 3 and absent corneal reflexes. However, it was only neuroparalytic effect of the venom, which improved in due course of time with antivenoms. This case highlights the occurrence of both internal and external ophthalmoplegia, which would mimic brain death in many

2012 American Journal of Emergency Medicine

499. Reversible brain death after cardiopulmonary arrest and induced hypothermia. (PubMed)

protection. After rewarming to 36.5°C, neurologic examination showed no eye opening or response to pain, spontaneous myoclonic movements, sluggishly reactive pupils, absent corneal reflexes, and intact gag and spontaneous respirations. Over 24 hrs, remaining cranial nerve function was lost. The neurologic examination was consistent with brain death. Apnea test and repeat clinical examination after a duration of 6 hrs confirmed brain death. Death was pronounced and the family consented to organ donation (...) . Twenty-four hrs after brain death pronouncement, on arrival to the operating room for organ procurement, the patient was found to have regained corneal reflexes, cough reflex, and spontaneous respirations. The care team faced the challenge of offering an adequate explanation to the patient's family and other healthcare professionals involved.Induced hypothermia and brain death determination.This represents the first published report in an adult patient of reversal of a diagnosis of brain death made

2011 Critical Care Medicine

500. Propofol and Etomidate Depress Cortical, Thalamic, and Reticular Formation Neurons During Anesthetic-Induced Unconsciousness. (PubMed)

an anesthetic effect; peak power occurred at 12 to 13 Hz during propofol infusion. There were 2 major peaks during etomidate anesthesia: one at 12 to 14 Hz and another at 7 to 8 Hz. The cats were heavily sedated, with depressed corneal and whisker reflexes; withdrawal to noxious stimulation remained intact.These data show that neurons in the cortex, thalamus, and reticular formation are similarly depressed by propofol and etomidate. Although anesthetic depression of neuronal activity likely contributes

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2011 Anesthesia and Analgesia

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