早产儿脑瘫合并Helveston综合征一例

Premature cerebral palsy complicated with Helveston syndrome: a case report

Helveston综合征是以分离性垂直斜、A型外斜视、双眼上斜肌亢进三联征为特征的斜视综合征。该文报道1例有早产脑瘫病史的患者,因双眼外斜视10余年就诊,确诊为Helveston综合征。插管全麻下行双眼外直肌后徙术+双眼上斜肌延长术,术后双眼眼位正,A征消失,交替遮盖双眼轻度上飘,眼球运动正常。该例Helveston综合征可能与早产儿脑瘫所致的中枢神经发育异常有关,提示临床中应多关注脑瘫患儿所引起的视觉障碍。

Helveston syndrome is a strabismus syndrome with a triad of dissociated vertical deviation, Apattern exotropia and binocular oblique overaction.This paper reported a case of patient with a history of premature cerebral palsy and strabismus for 10 years.The patient was admitted to our hospital for binocular exotropia and diagnosed with Helveston syndrome.The patient underwent binocular external rectus genioplasty plus superior oblique muscle lengthening under general anesthesia.Postoperatively,binocular positions was restored to normal and A-pattern exotropia disappeared.Alternate covering test revealed mild floating and normal eye movement.The incidence of Helveston syndrome may be related to abnormal development of central nervous system induced by premature cerebral palsy,suggesting that more attention should be paid to the visual dysfunction caused by cerebral palsy in premature infants.