Orbital metastases are rare and predominantly unilateral occurrences. Bilateral metastases affecting the extraocular muscles are extremely rare. A few case reports of bilateral metastases to extraocular muscles described binocular diplopia with conspicuous bilateral external ophthalmoplegia as an initial symptom. We report a case in which unilateral ptosis was an initial symptom and bilateral incomplete ophthalmoplegia was found on initial neurologic examination in invasive ductal carcinoma of the breast. The patient had hormone receptor-positive breast cancer, and so was treated by hormonal therapies and closely monitored. The presence of a secondary orbital lesion presents many difficulties of differential diagnosis and treatment. A thorough neurologic examination to detect ocular manifestations is most important for localization and broad differential diagnosis including mechanical orbital metastatic lesion.

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• Extraocular muscle enlargement
  Khizar Rana, Valerie Juniat, Sandy Patel, Dinesh Selva
  Graefe's Archive for Clinical and Experimental Ophthalmology.2022; 260(11): 3419.     CrossRef

No abstract available in English.

No abstract available in English.

Patients suffering from neurological disorder, such as cerebral infarctoin, often face serious swallowing difficulty and malnutrion. Although the importance of nutritional support has been well demonstrated, malnutrition remains a frequently neglected condition in the clinical setting.

In this study, we investigate the effectiveness of enteral nutritional support to neurological patients using nutritional beverage Nucare. 50 patients with acute and chronic neurological disease with eating problem were participated. 27 patients(experimental group : 17, control group :7), fed more than 7 days, were selected and statically analyzed by the changes of hematologic, biochemical parameters and nutritional index compared with control roup(p<0.05), which are good predictors of nutritional and hospital outcome.

This suggests that enteral nutritional support with Nucare can improve the nutritional status and clinical outcome of patient with acute and chronic neurological disease.