良性颅内压增高症误诊为眼部疾病临床分析

Clinical analysis of benign intracranial hypertension misdiagnosed as eye diseases

目的探讨在眼科临床诊治过程中对首诊于眼科的良性颅内压增高症（BIH）误诊的常见原因。方法回顾分析2005年3月至2012年3月神经内、外科及眼科收治的BIH病例51例，研究其临床资料及误诊情况。结果51例病例中有35例误诊为眼部疾病，其中误诊为视盘血管炎15例（42．9％），视神经乳头炎9例（25．7％），视神经网膜炎3例（8．6％），缺血性视神经病变1例（2．9％），青光眼2例（5．7％），外展神经麻痹5例（14．3％）。结论询问病史和神经系统检查不全面以及对良性颅内压增高症的临床特征不了解是误诊的主要原因。

Objective To discuss common reasons of benign intracranial hypertension （Bltt） mls- diagnosis as eye diseases in the primary survey in ophthalmology. Methods Retrospective study was taken to study the clinical data and misdiagnosis of the 51 cases with BIH from neurology, neu-rosurgery and ophthalmology department, from March 2005 to March 2012. Results Thirty-five of 51 cases were misdiagnosed as ocular diseases, 15 cases as optic disk vasculitis （42.9%）, 9 cases as papillitis （25.7%）, 3 cases as neuroretinitis （8.6%）, 1 case as isehemic optic neuropathy （2.9%）, 2 cases as glaucoma （5.7%）, 5 cases as abducens paralysis （14.3%）. Conclusions Main reasons of misdiagnosis for BIH include insufficient inquiry of case history, inadequate neurological exam and being not familiar with clinical features of BIH.