伴有中枢神经系统疾病的斜视患儿的临床分析

Clinical analysis of strabismus of children with central neurological diseases

目的:分析伴有中枢神经系统疾病的斜视及眼球运动异常患儿的临床特点。方法:回顾性分析郑州市第二人民医院47例伴有中枢神经系统疾病的斜视及眼球运动异常的临床资料,其中男25例,女22例。年龄范围6个月~12岁,平均(5.2±2.3)岁。随访6个月。结果:本研究中脑瘫、癫痫、脑积水及脑发育迟缓26例,内斜视及外斜视各13例,均为先天性共同性;脑肿瘤、脑脱髓鞘、脑动脉瘤及脑发育畸形共21例,包括共同性内斜视7例、外斜视2例、眼球震颤4例及内转障碍4例、上转障碍1例、下转障碍1例、外转障碍1例、上斜肌麻痹1例均为后天性。能够配合同视机检查者12例中,2例有同时视。结论:中枢神经系统疾病中以脑瘫和脑肿瘤居多。多数患儿伴有弱视及双眼视功能的破坏,所有患儿均无立体视。

Objective To analyze the clinical features of strabismus and ocular motility abnormality in children with central neurological diseases.Methods The clinical data of 47 cases of strabismus and ocular motility abnormality with central neurological diseases in Zhengzhou Second People’s Hospital were retrospectively analyzed.There were 25 males and 22 females.The average age was(5.2±2.3)years,ranged from 6 months to 12 years old.Results There were 26 cases with congenital concomitant,accompanied with cerebral palsy,epilepsy,hydrocephalus or developmental retardation.Among them,there were 13 children with exotropia and 13 children with esotropia.The other 21 cases with brain tumor,demyelinating encephalopathy,cerebral aneurysms and brain deformity,included 7 cases of concomitant esotropia,2 cases of exotropia,and 4 cases of nystagmus,4 cases of adduction disturbance,1 case of elevation disturbance,1 case of depression disturbance,1 case of abduction disturbance and 1 case of superior oblique paralysis,all of which were acquired.There were binocular simultaneous vision occurred in 2 cases among 12 children assessed with synoptophore.Conclusion Cerebral palsy and brain tumor are the most common in central neurological disease.The great majority of the patients have amblyopia or destruction of binocular vision.All patients have loss of stereoscopic vision.