Objective: There is only one neuropathologic report of congenital fibrosis of the extraocular muscles (CFEOM), and none of synergistic divergence. The aim of this report was to study the oculomotor nerve and the abduc...Objective: There is only one neuropathologic report of congenital fibrosis of the extraocular muscles (CFEOM), and none of synergistic divergence. The aim of this report was to study the oculomotor nerve and the abducens nerve in 2 such p atients with magnetic resonance imaging. Design: Observational case reports. Met hods: Ophthalmologic examination and thin-sectioned magnetic resonance imaging across the brainstem level were performed in 2 patients with CFEOM and synergist ic divergence. To confirm the accuracy of the procedure, we compared the results obtained with those of a control group of 40 individuals using the same techniq ue. Main Outcome Measures: The oculomotor nerve and the abducens nerve on magnet ic resonance imaging. Results: Magnetic resonance imaging disclosed bilateral hy poplasia of the oculomotor nerve in both patients, and absence of the abducens n erve on the affected side of synergistic divergence. The oculomotor and abducens nerves were observed in 80 of 80 eyes (100%) screened as controls. C onclusions: In both patients with CFEOM and synergistic divergence, the oculomot or nerve was hypoplastic bilaterally, and the abducens nerve was absent on the s ide exhibiting synergistic divergence.展开更多
目的:评价A型肉毒杆菌毒素(BTX-A)尿道外括约肌注射加巴氯芬口服治疗脊髓损伤后尿道外括约肌协同失调症(DESD)的临床效果。方法:尿流动力学检查证实脊髓损伤后DESD患者38例,男31例、女7例,平均年龄(36.5±17.8)岁。200 U BTX-A溶解...目的:评价A型肉毒杆菌毒素(BTX-A)尿道外括约肌注射加巴氯芬口服治疗脊髓损伤后尿道外括约肌协同失调症(DESD)的临床效果。方法:尿流动力学检查证实脊髓损伤后DESD患者38例,男31例、女7例,平均年龄(36.5±17.8)岁。200 U BTX-A溶解于8 ml生理盐水,使用尿道镜注射针分8点二平面注射于尿道外括约肌(1 ml/点)。术后第2日,随机选取12例患者(BTX-A+巴氯芬组)加服巴氯芬10 mg/次、3次/d,服用3个月,与另外26例患者作比较(BTX-A组)。4周后复查尿流动力学,随访2～9个月,比较治疗前后排尿症状、尿动力学检查结果的变化,并观察毒副作用。结果:治疗后1个月,膀胱贮尿和排尿功能有不同程度改善,最大尿流率、单次尿量、最大膀胱测压容积、膀胱顺应性增加,剩余尿量及充盈末逼尿肌压力下降,差异均有统计学意义(P<0.05)。BTX-A+巴氯芬组患者症状改善程度及膀胱顺应性明显优于单纯BTX-A组(P<0.05)。BTX-A+巴氯芬组有3例患者因出现神经系统不良反应而停药,其余患者无明显不良反应发生。结论:BTX-A注射加巴氯芬口服可以有效改善脊髓损伤后逼尿肌尿道外括约肌协同失调症患者的排尿障碍,长期疗效尚需进一步的随访观察。展开更多
文摘Objective: There is only one neuropathologic report of congenital fibrosis of the extraocular muscles (CFEOM), and none of synergistic divergence. The aim of this report was to study the oculomotor nerve and the abducens nerve in 2 such p atients with magnetic resonance imaging. Design: Observational case reports. Met hods: Ophthalmologic examination and thin-sectioned magnetic resonance imaging across the brainstem level were performed in 2 patients with CFEOM and synergist ic divergence. To confirm the accuracy of the procedure, we compared the results obtained with those of a control group of 40 individuals using the same techniq ue. Main Outcome Measures: The oculomotor nerve and the abducens nerve on magnet ic resonance imaging. Results: Magnetic resonance imaging disclosed bilateral hy poplasia of the oculomotor nerve in both patients, and absence of the abducens n erve on the affected side of synergistic divergence. The oculomotor and abducens nerves were observed in 80 of 80 eyes (100%) screened as controls. C onclusions: In both patients with CFEOM and synergistic divergence, the oculomot or nerve was hypoplastic bilaterally, and the abducens nerve was absent on the s ide exhibiting synergistic divergence.
