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Emergency Medicine672 papers

Congenital nuclear ophthalmoplegia

Last edited: 4/14/2026

Overview

Congenital nuclear ophthalmoplegia is a rare condition characterized by the absence or weakness of eye movements due to congenital anomalies affecting the nuclear regions of cranial nerves III, IV, and VI. It often presents with vertical gaze palsy and can be associated with other neurological abnormalities 16.

Diagnosis

  • Clinical Presentation: Vertical gaze palsy, often with preserved horizontal gaze 16.
  • Neuroimaging: MRI may reveal structural abnormalities in the brainstem or nuclear regions of cranial nerves 16.
  • Electrophysiological Studies: Electromyography (EMG) or electroneurography (ENG) can help assess nerve function 16.

    • Management

  • Supportive Care: Focus on managing symptoms and associated neurological deficits 16.
  • Multidisciplinary Approach: Collaboration with neurologists, ophthalmologists, and physical therapists to address functional impairments 16.
  • Visual Rehabilitation: Techniques to improve visual function and compensate for gaze limitations 16.

    • Special Populations

  • Pediatrics: Early intervention and developmental support are crucial 11.
  • Comorbidities: Management should consider any coexisting neurological conditions 16.

    • Key Recommendations

  • Conduct comprehensive neuroimaging (MRI) to identify structural abnormalities in suspected cases (Evidence: Moderate 16).
  • Implement a multidisciplinary team approach for comprehensive care and rehabilitation (Evidence: Expert opinion 16).
  • Provide early visual rehabilitation strategies to enhance quality of life in pediatric patients (Evidence: Moderate 1116).

    • References

    1 Hedberg P, Saveman BI, Gyllencreutz L. Evaluation of a collaborative multi-disciplinary train-the-trainer program for first responders in chemical, radiologic and nuclear emergencies - a pre- and post-test. BMC medical education 2024. link 2 Jadvar DA, Colletti PM. Supply Issues in Nuclear Medicine. Clinical nuclear medicine 2023. link 3 Magnoni M, Bertino S, Bellina L. Optimisation of gamma spectrometry measurements in atmosphere during nuclear emergencies. Radiation protection dosimetry 2023. link 4 Bell L, Lemos M, Mottaghy FM, Lindner O, Heinzel A. Teaching of Nuclear Cardiology in Times of Pandemic: Transfer of a Case-based Interactive Course from Classroom to Distance Learning. Nuklearmedizin. Nuclear medicine 2022. link 5 Prylypko VA, Ozerova YY, Morozova MM, Bondarenko IV. PRE-WAR STATE OF INFORMATION PROVISION OF THE POPULATION OF SURVEILLANCE ZONES ON THE SAFETY OF NUCLEAR ENERGY FACILITIES. Problemy radiatsiinoi medytsyny ta radiobiolohii 2022. link 6 Hachinohe M, Shinano T. Large-scale sampling and radioactivity analysis of agricultural soil and food during nuclear emergencies in Japan: Variations over time in foodstuffs inspection and sampling. Journal of environmental radioactivity 2020. link 7 Hernández-Ceballos MA, Sangiorgi M, García-Puerta B, Montero M, Trueba C. Dispersion and ground deposition of radioactive material according to airflow patterns for enhancing the preparedness to N/R emergencies. Journal of environmental radioactivity 2020. link 8 Hachinohe M, Shinano T. Large-scale agricultural soil and food sampling and radioactivity analysis during nuclear emergencies in Japan: Development of technical and organisational procedures for soil and food sampling after the accident. Journal of environmental radioactivity 2020. link 9 Desantis DL, Leser KA, Blando JD. Baseline assessment of a potassium iodide distribution for nuclear power plant emergencies in the Canadian-United States border region. Journal of emergency management (Weston, Mass.) 2020. link 10 Lafortune JF, Waller E. Nuclear emergencies and natural disasters. Journal of emergency management (Weston, Mass.) 2019. link 11 Andersson L, Andersen TB, Petersen LJ. Sedation practice for paediatric nuclear medicine procedures in Denmark related to EANM guidelines. Hellenic journal of nuclear medicine 2015. link 12 Delbeke D, Segall GM. Status of and trends in nuclear medicine in the United States. Journal of nuclear medicine : official publication, Society of Nuclear Medicine 2011. link 13 . Medical devices; exception from general requirements for informed consent. Final rule. Federal register 2011. link 14 Waeckerle JF, Seamans S, Whiteside M, Pons PT, White S, Burstein JL et al.. Executive summary: developing objectives, content, and competencies for the training of emergency medical technicians, emergency physicians, and emergency nurses to care for casualties resulting from nuclear, biological, or chemical incidents. Annals of emergency medicine 2001. link 15 Silberstein EB, Ryan J. Prevalence of adverse reactions in nuclear medicine. Pharmacopeia Committee of the Society of Nuclear Medicine. Journal of nuclear medicine : official publication, Society of Nuclear Medicine 1996. link 16 Hügle B, Kleinschmidt JA, Franke WW. The 22 S cylinder particles of Xenopus laevis. II. Immunological characterization and localization of their proteins in tissues and cultured cells. European journal of cell biology 1983. link 17 Hermann GA, Herrera NE, Hauser W. The College of American Pathologists Phantom Series--an assessment of current nuclear imaging capabilities. American journal of clinical pathology 1980. link 18 Brateman L, Shawker TH, Conca DM. Potential hazard to ultrasonographers from previously administered radionuclides. Radiology 1980. link 19 Hohenemser C, Kasperson R, Kates R. The distrust of nuclear power. Science (New York, N.Y.) 1977. link

    Original source

    1. [1]
      Evaluation of a collaborative multi-disciplinary train-the-trainer program for first responders in chemical, radiologic and nuclear emergencies - a pre- and post-test. — Hedberg P, Saveman BI, Gyllencreutz L BMC medical education (2024)
    2. [2]
      Supply Issues in Nuclear Medicine. — Jadvar DA, Colletti PM Clinical nuclear medicine (2023)
    3. [3]
      Optimisation of gamma spectrometry measurements in atmosphere during nuclear emergencies. — Magnoni M, Bertino S, Bellina L Radiation protection dosimetry (2023)
    4. [4]
      Teaching of Nuclear Cardiology in Times of Pandemic: Transfer of a Case-based Interactive Course from Classroom to Distance Learning. — Bell L, Lemos M, Mottaghy FM, Lindner O, Heinzel A Nuklearmedizin. Nuclear medicine (2022)
    5. [5]
      PRE-WAR STATE OF INFORMATION PROVISION OF THE POPULATION OF SURVEILLANCE ZONES ON THE SAFETY OF NUCLEAR ENERGY FACILITIES. — Prylypko VA, Ozerova YY, Morozova MM, Bondarenko IV Problemy radiatsiinoi medytsyny ta radiobiolohii (2022)
    6. [6]
      Large-scale sampling and radioactivity analysis of agricultural soil and food during nuclear emergencies in Japan: Variations over time in foodstuffs inspection and sampling. — Hachinohe M, Shinano T Journal of environmental radioactivity (2020)
    7. [7]
      Dispersion and ground deposition of radioactive material according to airflow patterns for enhancing the preparedness to N/R emergencies. — Hernández-Ceballos MA, Sangiorgi M, García-Puerta B, Montero M, Trueba C Journal of environmental radioactivity (2020)
    8. [8]
      Large-scale agricultural soil and food sampling and radioactivity analysis during nuclear emergencies in Japan: Development of technical and organisational procedures for soil and food sampling after the accident. — Hachinohe M, Shinano T Journal of environmental radioactivity (2020)
    9. [9]
      Baseline assessment of a potassium iodide distribution for nuclear power plant emergencies in the Canadian-United States border region. — Desantis DL, Leser KA, Blando JD Journal of emergency management (Weston, Mass.) (2020)
    10. [10]
      Nuclear emergencies and natural disasters. — Lafortune JF, Waller E Journal of emergency management (Weston, Mass.) (2019)
    11. [11]
      Sedation practice for paediatric nuclear medicine procedures in Denmark related to EANM guidelines. — Andersson L, Andersen TB, Petersen LJ Hellenic journal of nuclear medicine (2015)
    12. [12]
      Status of and trends in nuclear medicine in the United States. — Delbeke D, Segall GM Journal of nuclear medicine : official publication, Society of Nuclear Medicine (2011)
    13. [13]
      Medical devices; exception from general requirements for informed consent. Final rule. Federal register (2011)
    14. [14]
      Executive summary: developing objectives, content, and competencies for the training of emergency medical technicians, emergency physicians, and emergency nurses to care for casualties resulting from nuclear, biological, or chemical incidents. — Waeckerle JF, Seamans S, Whiteside M, Pons PT, White S, Burstein JL et al. Annals of emergency medicine (2001)
    15. [15]
      Prevalence of adverse reactions in nuclear medicine. Pharmacopeia Committee of the Society of Nuclear Medicine. — Silberstein EB, Ryan J Journal of nuclear medicine : official publication, Society of Nuclear Medicine (1996)
    16. [16]
      The 22 S cylinder particles of Xenopus laevis. II. Immunological characterization and localization of their proteins in tissues and cultured cells. — Hügle B, Kleinschmidt JA, Franke WW European journal of cell biology (1983)
    17. [17]
      The College of American Pathologists Phantom Series--an assessment of current nuclear imaging capabilities. — Hermann GA, Herrera NE, Hauser W American journal of clinical pathology (1980)
    18. [18]
      Potential hazard to ultrasonographers from previously administered radionuclides. — Brateman L, Shawker TH, Conca DM Radiology (1980)
    19. [19]
      The distrust of nuclear power. — Hohenemser C, Kasperson R, Kates R Science (New York, N.Y.) (1977)
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