warfarin and Blepharoptosis

Topics: Anticoagulants; Blepharoptosis; Carotid Artery, Internal, Dissection; Cluster Headache; Diagnosis, Differential; Edema; Essential Tremor; Humans; Magnetic Resonance Angiography; Male; Middle Aged; Vasodilator Agents; Verapamil; Vertigo; Warfarin

We report facial palsy as the sole cranial neuropathy complicating an ipsilateral internal carotid artery dissection. A previously healthy 44-year-old man developed retro-orbital and temporal headache with associated nausea while engaged in modest physical exercise. On the following morning he noticed a left ptosis and miotic pupil. One week later he woke with a left facial weakness. On the same day he had a 90-minute episode of expressive dysphasia. Magnetic resonance imaging and angiography demonstrated left internal carotid artery dissection. The temporal association between our patient's facial nerve palsy and typical features of spontaneous internal carotid artery dissection suggests a common aetiology. We suggest that involvement of the VII cranial nerve in isolation followed disruption of an anomalous nutrient artery. The delay in clinical manifestation may imply extension of the dissection.

Topics: Adult; Aneurysm; Anticoagulants; Blepharoptosis; Brain; Carotid Artery, Internal, Dissection; Deglutition Disorders; Exercise; Facial Paralysis; Heparin, Low-Molecular-Weight; Humans; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Tinzaparin; Warfarin

To describe the atypical localization and unusual clinical manifestation of an internal carotid artery dissection.. We examined a 43-year-old woman who had sudden onset of left ptosis and miosis with vague dysesthesia around her eye.. Her examination showed an intrapetrous carotid artery dissection.. The intrapetrous segment is an extremely rare localization for an internal carotid artery dissection. The differential diagnosis of acute Horner syndrome should include carotid dissection, which is usually accompanied by other neurologic manifestations.

Topics: Adult; Anticoagulants; Aortic Dissection; Blepharoptosis; Carotid Artery Diseases; Carotid Artery, Internal; Cerebral Angiography; Diagnosis, Differential; Female; Heparin; Horner Syndrome; Humans; Petrous Bone; Warfarin

The possible pharmacological interaction was studied between N-2-(p-chlorophenoxy)-isobutyryl-N'-morpholinomethylurea (plafibride, ITA 104) and a series of products with analgesic, anticoagulant, antidepressant, antidiabetic, Beta-blocking, diuretic, hypotensive, nootropic, tranquillizing and vasodilator activities. In the experiment the LD50 of each product was compared with that found for the joint administration of the product and plafibride. Plafibride increased the acute toxicity of reserpine and potentiated its hypothermic effect in the mouse; it did not alter its effect on arterial pressure in dog and rat nor its effect on palpebral ptosis in the mouse. Although plafibride did not potentiate the acute toxicity of warfarin, its anticoagulant activity was potentiated, possibly due to the movement of warfarin from its binding sites to the plasma proteins.

Topics: Animals; Blepharoptosis; Blood Pressure; Body Temperature; Clofibrate; Clofibric Acid; Dogs; Drug Interactions; Mice; Rats; Rats, Inbred Strains; Reserpine; Warfarin