眼外肌麻痹的病因探讨及治疗分析

The study of etiology and treatment of external ophthalmoplegia

目的综合眼外肌麻痹患者的临床表现,进行病因探讨和预后分析。方法总结67例眼外肌麻痹患者的临床表现,采用眼位、眼球运动、复视检查、CT、MRI、CTA、DSA影像学检查、生化检查、新斯的明检查等手段确定其病因,并对患者进行为期2年的随访,进行预后分析。结果眼外肌麻痹主要临床表现有复视(74.63%)、头晕(62.69%)、恶心(53.73%)、发热(49.25%)、眼位偏斜(34.33%)、眼睑下垂(25.37%)、眼球活动障碍(20.90%)、血糖升高(17.91%)等;病因依次为糖尿病(17.91%)、颅脑外伤(14.93%)、血管疾病(13.43%)、炎症(10.45%)、重症肌无力(8.96%)等。随访2年后,有14例(20.90%)复发。结论眼外肌麻痹临床症状复杂,病因多种多样,预后较好。

Objective To study the etiology and treatment by synthesizing the clinical manifestations of patients with external ophthalmoplegia. Methods Summarized the clinical manifestations of 67 patients with external ophthalmoplegia, us- ing ocular position,eye movement, double vision examination, CT, MRI, CTA and DSA imaging examination, biochemical ex- amination, neostigmine examination means to determine its cause, and for a period of 2 years of follow-up in patients to analyse the prognosis. Results External ophthalmoplegia main clinical manifestations were diplopia （74.63%）, dizziness （62.69%）, nau- sea （53.73%）, fever （49.25%）, eye deviation （34.33%）, eyelid prolapse （25.37%）, eye movement disorder （20.90%）, blood glucose increasing （17.91%）; causes followed by diabetes （17.91%）, craniocerebral trauma （14.93%）, vascular disease （13.43%）, inflammation （10.45%）, myasthenia grais （8.96%） ; follow-up after two years, 14 cases （20.90%） recurrence＆ Conclusion External ophthalmoplegia has complicated clinical symptoms, etiology is varied and the prognosis is well.