Prednisone

Cranial mononeuropathy VI is a nerve disorder that causes people to see two of the same image (double vision).

Abducens palsy; Lateral rectus palsy

Cranial mononeuropathy VI is damage to the sixth cranial (skull) nerve. This nerve, also called the abducens nerve, helps control eye movement.

Disorders of this nerve can occur with:

• Brain aneurysms
• Diabetic neuropathy
• Increased pressure in the skull (intracranial pressure)
• Infections (such as meningitis or sinusitis)
• Tissue damage from loss of blood flow (infarction)
• Trauma (caused by head injury or accidentally during surgery)
• Tumors

In some people, there is no obvious cause.

Because there are common nerve pathways through the skull, the disorder may affect other cranial nerves (such as the third or fourth cranial nerve).

Symptoms may include:

• Double visionwhen looking to one side (people who are blind in one eye cannot have double vision)
• Headaches
• Pain

Tests typically show that one eye has trouble looking to the side, while the other eye moves normally. An examination shows the eyes do not line up -- either at rest, or when looking in the direction of the weak eye.

Your health care provider will do a complete examination to determine the possible effect on other parts of the nervous system. Depending on the suspected cause, you may need:

• Blood tests
• Head imaging study (such as an MRI or CT scan)
• Spinal tap(lumbar puncture)

You may need to be referred to a doctor who specializes in visual problems related to the nervous system (neuro-ophthalmologist).

If the health care provider finds a cause, medications called corticosteroids can reduce swelling and relieve pressure on the nerve. Sometimes, the condition may disappear without treatment. People with diabetes may benefit from close control of blood sugar levels.

Until the nerve heals, wearing an eye patch may relieve double vision.

Treating the cause may improve the condition. Even if the cause is never found, the condition may improve.

Complications may include permanent vision changes.

Call your health care provider if you have double vision.

There is no way to prevent this condition. However, people with diabetes may reduce the risk by controlling their blood sugar.

Ovarian overproduction of androgens is a condition in which the female ovaries make too much testosterone. This leads to the development of male characteristics in a woman. Other hormones, called androgens, from other parts of the body can also cause the development of male characteristics in women.

In healthy women, the ovaries and adrenal glands produce about 40 - 50% of the body's testosterone. Both tumors of the ovaries and polycystic ovary syndrome (PCOS) can cause excess androgen production.

Cushing's disease, an abnormality in the pituitary gland, causes excess amounts of corticosteroids, which cause masculine body changes in women. Also, tumors in the adrenal glands can cause overproduction of androgens and lead to male body characteristics in women.

Hyperandrogenism:

• Acne
• Amenorrhea(absence of menstrual periods)
• Changes in female body contours
• Decrease in breast size
• Increase in body hair in a male pattern (hirsutism) such as on the face, chin, and abdomen
• Oily skin

Virilization:

• Clitoromegaly (enlargement of the clitoris)
• Deepening of the voice
• Increase in muscle mass
• Temporal balding (thinning hair and hair loss)

• 17-hydroxyprogesterone test
• ACTH test
• CT scan
• DHEA blood test
• Glucose test
• Insulin test
• Pelvic ultrasound
• Prolactin (if periods are infrequent or absent) test
• Testosterone test
• Total cholesterol test
• TSH test (if there is hair loss)

Treatment depends on the problem that is causing the increased androgen production. Medications can be given to decrease hair production in patients who have excess body hair (hirsutism) or to regulate menstrual cycles. In some cases, surgery may be necessary to remove an ovarian or adrenal tumor.

The success of the treatment depends on what caused the excess androgen production. If the condition is caused by an ovarian tumor, surgical removal of the tumor may correct the problem. Most ovarian tumors are not cancerous (benign), and will not come back after they've been removed.

In polycystic ovary syndrome, the following can reduce symptoms caused by increased androgen levels:

• Careful monitoring
• Dietary changes
• Medications
• Regular vigorous exercise

Infertility is a possible complication.

Women with polycystic ovary syndrome may be at increased risk for:

• Diabetes
• High blood pressure
• High cholesterol
• Obesity
• Uterine cancer

There is no known prevention. Maintaining a normal weight through healthy diet and regular exercise can reduce your chances of any long-term complications.

Lobo RA. Hyperandrogenism: physiology, etiology, differential diagnosis, management. In: Katz V, Lobo RA, Lentz G, Gershenson D, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 40.

Bulun SE, Adashi EY. The physiology and pathology of the female reproductive axis. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 16.

• problems with your vision;
• swelling, rapid weight gain, feeling short of breath;
• severe depression, unusual thoughts or behavior, seizure (convulsions);
• bloody or tarry stools, coughing up blood;
• pancreatitis (severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate);
• low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or
• dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious prednisone side effects may include:

• sleep problems (insomnia), mood changes;
• acne, dry skin, thinning skin, bruising or discoloration;
• slow wound healing;
• increased sweating;
• headache, dizziness, spinning sensation;
• nausea, stomach pain, bloating; or
• changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088