表现为后核间性眼肌麻痹的胆脂瘤1例及文献回顾

Posterior Internuclear Ophthalmoplegia as a Sign of Intracranial Cholesteatoma:A Case Report and Review of Literatures

背景与目的:后核间性眼肌麻痹是一种少见的眼球水平同向运动障碍,本例为后核间性眼肌麻痹的第四脑室巨大胆脂瘤,肿瘤体积大而临床症状出现较晚且较轻,最初被误诊。本文旨在探讨误诊原因,以期引起临床医生的重视。方法:通过分析病例的临床特点和回顾文献,与常见的重症肌无力、糖尿病眼肌病变、多发性硬化等内科疾病进行鉴别诊断。结果:通过详细的神经系统检查、生化、电生理、影像学检查等可以排除引起后核间性眼肌麻痹的其他疾病。结论:第四脑室胆脂瘤是后核间性眼肌麻痹的少见病因之一。

BACKGROUND ＆ OBJECTIVE： Posterior internuclear ophthalmoplegia is a rare sign of intracranial cholesteatoma. In this article, a case with a giant cholesteatoma in fourth ventricle manifesting as posterior internuclear opthalmoplegia was reported and literatures were reviewed. METHODS： Clinical features of the case were analyzed and differential diagnosis, such as myasthenia gravis,diabetis and multiple sclerosis, were discussed. RESULTS： The diagnosis of intracranial cholesteatoma in this case manifesting as posterior internuclear opthalmoplegia was confirmed with thorough physical examination, laboratory test, electrophysiological examination and MRI scanning. CONCLUSIONS： Cholesteatoma is a rare cause of posterior internuclear ophthalmoplegia.