Acupuncture therapy for isolated ischemic oculomotor nerve palsy: A case report

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Abstract

Background:

Isolated ischemic oculomotor nerve palsy as a type of ophthalmic disease is rarely observed in clinical practice. Quality of life is frequently impacted by isolated ischemic oculomotor nerve palsy due to its lack of treatment options and long-term visual impairment. We describe an acupuncture-treated instance of isolated ischemic oculomotor paralysis.

Methods:

Acupoints including Jingming (BL 1), Chengqi (ST 1), Cuanzhu (BL 2), and Sizhukong (TE 23) on the right side, and bilateral Fengchi (GB 20), Waiguan (TE 5), Hegu (LI 4), and Zulinqi (GB 41) were selected for needling. Each treatment lasted for 30 minutes, once every other day. Acupuncture treatment was administered for a total of 11 times.

Results:

Acupuncture is a promising treatment option for isolated ischemic oculomotor nerve palsy.

Conclusions:

Ischemic oculomotor nerve paralysis can affect the quality of life of patients. Acupuncture intervention can promote the recovery of the disease is a very effective treatment measure.

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Most cited references 23

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Microglial/Macrophage Polarization Dynamics following Traumatic Brain Injury.

Alok Kumar, Dulce-Mariely Álvarez-Croda, Bogdan A Stoica … (2016)

Activated microglia and macrophages exert dual beneficial and detrimental roles after central nervous system injury, which are thought to be due to their polarization along a continuum from a classical pro-inflammatory M1-like state to an alternative anti-inflammatory M2-like state. The goal of the present study was to analyze the temporal dynamics of microglia/macrophage polarization within the lesion micro-environment following traumatic brain injury (TBI) using a moderate-level controlled cortical impact (CCI) model in mice. We performed a detailed phenotypic analysis of M1- and M2-like polarized microglia/macrophages, as well as nicotinamide adenine dinucleotide phosphate oxidase (NOX2) expression, through 7 days post-injury using real-time polymerase chain reaction (qPCR), flow cytometry and image analyses. We demonstrated that microglia/macrophages express both M1- and M2-like phenotypic markers early after TBI, but the transient up-regulation of the M2-like phenotype was replaced by a predominant M1- or mixed transitional (Mtran) phenotype that expressed high levels of NOX2 at 7 days post-injury. The shift towards the M1-like and Mtran phenotype was associated with increased cortical and hippocampal neurodegeneration. In a follow up study, we administered a selective NOX2 inhibitor, gp91ds-tat, to CCI mice starting at 24 h post-injury to investigate the relationship between NOX2 and M1-like/Mtran phenotypes. Delayed gp91ds-tat treatment altered M1-/M2-like balance in favor of the anti-inflammatory M2-like phenotype, and significantly reduced oxidative damage in neurons at 7 days post-injury. Therefore, our data suggest that despite M1-like and M2-like polarized microglia/macrophages being activated after TBI, the early M2-like response becomes dysfunctional over time, resulting in development of pathological M1-like and Mtran phenotypes driven by increased NOX2 activity.

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HMGB1 as a Key Mediator of Immune Mechanisms in Ischemic Stroke.

Vikramjeet Singh, Stefan Roth, Roland Veltkamp … (2016)

Stroke is the leading cause of morbidity and mortality worldwide. Inflammatory cascades have a major impact on outcome and regeneration after ischemic stroke. High-mobility group box 1 (HMGB1) has come into the focus of experimental and clinical stroke research because it is released from necrotic brain tissue and its differential redox forms attract and activate immune cells after ischemic brain injury. HMGB1 is a potent inducer of inflammatory cascades, and thereby, secondary deterioration of neurological outcome.

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Incidence and Etiologies of Acquired Third Nerve Palsy Using a Population-Based Method.

Chengbo Fang, Jacqueline A. Leavitt, David Hodge … (2017)

Among cranial nerve palsies, a third nerve palsy is important because a subset is caused by life-threatening aneurysms. However, there is significant disagreement regarding its incidence and the reported etiologies.

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Author and article information

Contributors

Guan Xu:

ORCID: https://orcid.org/0009-0003-9138-2058

Kelin He

Xiao Ye

Songhao Ning

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MD

Title: Medicine

Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: 19 April 2024

Publication date (Electronic): 19 April 2024

Volume: 103

Issue: 16

Electronic Location Identifier: e37850

Affiliations

[a ]Zhejiang Chinese Medical University, Hangzhou, China

[b ]Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China

[c ]Confucius Institute, University of Coimbra, Coimbra, Portugal.

Author notes

[* ] Correspondence: Quanai Zhang, Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China (e-mail: 1hy45656@ 123456126.com ).

Author information

Guan Xu https://orcid.org/0009-0003-9138-2058

Quanai Zhang https://orcid.org/0000-0002-2008-3697

Article

Publisher ID: MD-D-23-10644 Accession ID: 00053

DOI: 10.1097/MD.0000000000037850

PMC ID: 11029924

PubMed ID: 38640311

SO-VID: 4a79380e-a45d-4d23-adf9-5b7ac661e7af

License:

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 01 December 2023

Date revision received : 28 February 2024

Date accepted : 20 March 2024

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Keywords: acupuncture therapy,case report,isolated ischemic oculomotor nerve palsy,microvascular ischemia

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Keywords: acupuncture therapy, case report, isolated ischemic oculomotor nerve palsy, microvascular ischemia

Acupuncture therapy for isolated ischemic oculomotor nerve palsy: A case report

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Most cited references 23

Microglial/Macrophage Polarization Dynamics following Traumatic Brain Injury.

HMGB1 as a Key Mediator of Immune Mechanisms in Ischemic Stroke.

Incidence and Etiologies of Acquired Third Nerve Palsy Using a Population-Based Method.

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