Öz
Millard-Gubler Sendromu (MGS), 6. ve 7. kraniyal sinir periferik felcine eşlik eden vücut karşı tarafında hemiparezi ya da hemipleji ile seyreder. Etiyolojide yaşa göre değişkenlik görülmekle birlikte pons hasarı ön plandadır. Tedavi ve prognoz esas olarak etiyolojiye bağlıdır. Kliniğimize sağ gözde içe kayma şikayetiyle başvuran 18 yaşındaki erkek hastada Millard-Gubler Sendromu düşünülmüş, ancak etiyoloji belirlenememiştir. Hastaya şaşılık ve lagoftalmus nedeniyle operasyonlar uygulanmış, sonuç olarak ortofori sağlanmış ve lagoftalmus düzeltilmiştir. Hastalara nöroloji kliniğinin bilgisi dışında yapılacak cerrahi müdahalelerin, hastalığın oküler bulgularını maskeleyebileceği unutulmamalı, multidisipliner yaklaşımla, nörolojik rehabilitasyonu da içeren konservatif tedavi uygulanmalıdır.
Anahtar Kelimeler
Millard-Gubler sendromu 6. kraniyal sinir felci 7. kraniyal sinir felci şaşılık lagoftalmus
Kaynakça
- Sakuru R, Elnahry AG, Bollu PC. Millard Gubler Syndrome. StatPearls [Internet] 2020 [cited 15 Jan 2020]. Available from: https://pubmed.ncbi.nlm.nih.gov/30422502/
- Walusinski O. Adolphe Gubler (1821-1879) or Parisian neurology outside La Salpêtrière in the age of Jean-Martin Charcot. Rev Neurol (Paris) 2019; 175 (4): 207-16.
- Ceballos-Lizarraga R, Palomino-Díaz C, Romero-Figueroa JÁ. Wall-Eyed Monocular Internuclear Ophthalmoplegia (WEMINO) and Millard-Gubler Syndromes in a patient with isolated pontine infarction: Topographic, oculomotor, and radiological analysis of two very uncommon conditions. Case Rep Neurol 2019; 11 (2): 230-7.
- Prasad R, Kapoor K, Srivastava A, Mishra O. Neurocysticercosis presenting as Millard Gubler syndrome. Journal of Neurosciences Rural Practice 2012; 3 (3): 375-7.
- Rose DZ, Parra-Herran C, Petito CK, Post MJ. Restricted diffusion of pus in the subarachnoid space: MRSA meningo-vasculitis and progressive brainstem ischemic strokes – A case report. Case Reports in Neurology 2010; 2 (2): 101-10.
- Li XT, Yuan JL, Hu WL. Vertebrobasilar artery dissection manifesting as Millard-Gubler Syndrome in a young ischemic stroke patient: A case report. World Journal of Clinical Cases 2019; 7 (1): 73-8.
- Kesikburun S, Safaz İ, Alaca R. Pontine cavernoma hemorrhage leading to Millard-Gubler Syndrome. American Journal of Physical Medicine & Rehabilitation 2011; 90 (3): 263.
- Ben Nsir A, Badri M, Kassar AZ, Hammouda KB, Jemel H. Hemangiopericytoma of the cerebellopontine angle: A wolf in sheep’s clothing. Brain Tumor Research and Treatment 2016; 4 (1): 8-12.
- Matsuyama T, Masuda A. A rare case of delayed traumatic Millard-Gubler Syndrome. No Shinkei Geka 1992; 20 (6): 697-9.
- Dourado Leite R, Freitas C, Guimaraes S. Vertical muscle transposition with silicone band belting in VI nerve palsy. BMJ Case Rep 2016 doi: 10.1136/bcr-2016-216722
Öz
Millard-Gubler Syndrome (MGS) progresses with contralateral hemiparesis or hemiplegia accompanying peripheral palsies of 6th and 7th cranial nerves. Although the etiology varies according to age, pons damage is prominent. Treatment and prognosis mainly depend on etiology. An 18-year-old male patient applied to our clinic with the complaint of crossing in the right eye, Millard-Gubler Syndrome was considered but the etiology could not determine. Operations were performed to the patient due to strabismus and lagophthalmos, as a result orthophoria was provided and lagophthalmos was corrected. It should be kept in mind that may mask ocular findings of the disease if surgical interventions to be performed on patients without the knowledge of the neurology clinic, with a multidisciplinary approach, conservative treatment, including neurological rehabilitation should be administered.
Anahtar Kelimeler
Millard-Gubler Syndrome 6. cranial nerve palsy 7. cranial nerve palsy strabismus lagophthalmos
Kaynakça
- Sakuru R, Elnahry AG, Bollu PC. Millard Gubler Syndrome. StatPearls [Internet] 2020 [cited 15 Jan 2020]. Available from: https://pubmed.ncbi.nlm.nih.gov/30422502/
- Walusinski O. Adolphe Gubler (1821-1879) or Parisian neurology outside La Salpêtrière in the age of Jean-Martin Charcot. Rev Neurol (Paris) 2019; 175 (4): 207-16.
- Ceballos-Lizarraga R, Palomino-Díaz C, Romero-Figueroa JÁ. Wall-Eyed Monocular Internuclear Ophthalmoplegia (WEMINO) and Millard-Gubler Syndromes in a patient with isolated pontine infarction: Topographic, oculomotor, and radiological analysis of two very uncommon conditions. Case Rep Neurol 2019; 11 (2): 230-7.
- Prasad R, Kapoor K, Srivastava A, Mishra O. Neurocysticercosis presenting as Millard Gubler syndrome. Journal of Neurosciences Rural Practice 2012; 3 (3): 375-7.
- Rose DZ, Parra-Herran C, Petito CK, Post MJ. Restricted diffusion of pus in the subarachnoid space: MRSA meningo-vasculitis and progressive brainstem ischemic strokes – A case report. Case Reports in Neurology 2010; 2 (2): 101-10.
- Li XT, Yuan JL, Hu WL. Vertebrobasilar artery dissection manifesting as Millard-Gubler Syndrome in a young ischemic stroke patient: A case report. World Journal of Clinical Cases 2019; 7 (1): 73-8.
- Kesikburun S, Safaz İ, Alaca R. Pontine cavernoma hemorrhage leading to Millard-Gubler Syndrome. American Journal of Physical Medicine & Rehabilitation 2011; 90 (3): 263.
- Ben Nsir A, Badri M, Kassar AZ, Hammouda KB, Jemel H. Hemangiopericytoma of the cerebellopontine angle: A wolf in sheep’s clothing. Brain Tumor Research and Treatment 2016; 4 (1): 8-12.
- Matsuyama T, Masuda A. A rare case of delayed traumatic Millard-Gubler Syndrome. No Shinkei Geka 1992; 20 (6): 697-9.
- Dourado Leite R, Freitas C, Guimaraes S. Vertical muscle transposition with silicone band belting in VI nerve palsy. BMJ Case Rep 2016 doi: 10.1136/bcr-2016-216722
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 22 Aralık 2021 |
| Gönderilme Tarihi | 4 Ağustos 2020 |
| Yayımlandığı Sayı | Yıl 2021Cilt: 60 Sayı: 4 |
