眼肌麻痹少见病因的临床特点分析

Clinical characteristics of rare causes of ophthalmoplegia

目的探讨眼肌麻痹少见病因的临床特点,为尽早明确病因诊断,及时对应治疗提供参考。方法对2014年1月至2018年6月就诊的少见病因眼肌麻痹23例患者的临床资料进行回顾性分析,进行病因分类和各自临床特点的分析总结。结果 23例少见病因眼肌麻痹包括:格林-巴利综合征(GBS) 3例,米勒费雪综合征(MFS) 2例,Bickerstaff's脑干脑炎(BBE) 1例,桥本甲状腺炎1例,脑膜癌1例,神经梅毒1例,Wernicke脑病3例,糖尿病性眼肌麻痹5例,垂体卒中1例,颈动脉海绵窦瘘1例,眼肌麻痹型偏头痛1例,Tolosa-Hunt综合征2例,进行性核上性眼肌麻痹1例。不同病因的患者,其病史、临床表现、辅助检查及治疗预后等均各有其独特的临床特点。结论熟悉少见病因所致眼肌麻痹的临床特点,是查找眼肌麻痹少见病因、明确诊断的关键。

Objective To explore the clinical characteristics of rare etiology of ophthalmoplegia to provide reference for early diagnosis and timely treatment for patients with ophthalmoplegia. Methods The clinical data of 23 patients with ophthalmoplegia from different rare etiology were retrospectively analyzed. Classification of etiology and analysis and summary of their respective clinical characteristics. Results In the rare causes of ophthalmoplegia,there were 3 cases of Guillain-Barré syndrome( GBS),2 cases of Miller Fisher syndrome( MFS),1 case of Bickerstaff’s brainstem encephalitis( BBE),1 case of Hashimoto’s thyroiditis,1 case of meningeal carcinoma,1 case of neurosyphilis,3 cases of Wernicke encephalopathy,5 cases of diabetic ophthalmoplegia,1 case of pituitary apoplexy,1 case of carotid cavernous fistula,1 case of ophthalmoplegic migraine,2 cases of Tolosa-Hunt syndrome,1 case of progressive supranuclear ophthalmoplegia. The patients with ophthalmoplegia of different etiologies manifested the unique clinical characteristics in history,clinical manifestations,adjuvant examinations and treatment prognosis. Conclusion Knowing the clinical characteristics of ophthalmoplegia caused by different rare etiology is the key to find out the causes and make definite diagnosis of ophthalmoplegia.