56例动眼神经麻痹患者的病因及临床特点分析

Analysis of the etiologies and clinical features of 56 patients with oculomotor nerve palsy

目的分析56例动眼神经麻痹患者的病因和临床特点。方法回顾性分析2016年1月至2017年12月在我院就诊的56例首诊症状包括动眼神经麻痹患者的临床资料,分析患者的病因及临床特点。结果动眼神经麻痹的病因前三位分别为糖尿病15例(26.8%),脑卒中13例(23.2%),重症肌无力8例(14.3%),其他病因有动脉瘤、肿瘤、炎性、外伤、甲状腺疾病、痛性眼肌麻痹、Miller-Fisher综合征及不明原因。临床症状:瞳孔受累18例,单侧病变50例,单纯性麻痹32例,部分麻痹47例。结论动眼神经麻痹病因纷繁复杂,本研究显示糖尿病占首位,其次为脑卒中和重症肌无力。重视对病史的采集和神经影像学检查的动态分析,能够帮助进一步阐明动眼神经麻痹的病因。

Objective To analyze the etiologies and clinical features of 56 patients with oculomotor nerve palsy.Methods The clinical data of 56 patients admitted in our hospital from January 2016 to December 2017 with initial symptoms oculomotor nerve palsy were retrospectively analyzed,and the etiologies and clinical characteristics of the patients were analyzed.Results The top three etiologies of oculomotor nerve palsy were diabetes in 15 cases(26.8%),stroke in 13 cases(23.2%)and myasthenia gravis in 8 cases(14.3%);other etiologies included aneurysm,tumor,inflammation,trauma,thyroid disease,painful ophthalmoplegia,Miller-Fisher syndrome and unknown causes.The clinical symptoms included pupil involvement in 18 cases,unilateral lesions in 50 cases,simple palsy in 32 cases and partial palsy in 47 cases.Conclusion The etiologies of oculomotor nerve palsy are very complicated.In this study,diabetes is the main cause of oculomotor nerve palsy,followed by stroke and myasthenia gravis.Paying more attention to the collection of medical history and the dynamic analysis of neuroimaging examination can help doctors to further elucidate the etiologies of oculomotor nerve palsy.