动眼神经麻痹33例临床分析  

Clinical characteristics of 33 patients with oculomotor nerve palsy

作　　者：井艳丽[1] 石亚军 周林甫[1] 李仓霞[1] 李敏昌[1] 安一菲 史锋 Jing Yanli;Shi Yajun;Zhou Linfu;Li Cangxia;Li Minchang;An Yifei;Shi Feng(Department of Neurology,the Third Hospital of PLA,xi Shan 721004,China)

机构地区：[1]解放军第三医院神经内科,陕西721000 [2]空军军医大学附属西京医院神经内科

出　　处：《脑与神经疾病杂志》2019年第8期474-479,共6页Journal of Brain and Nervous Diseases

摘　　要：目的探讨动眼神经麻痹(ONP)患者的临床表现及病因。方法分析2012年9月至2017年12月陕西解放军第三医院神经内科住院治疗的33例ONP患者的病例资料。结果33例ONP患者中单眼发病30例陕西(90.9%),双眼发病3例(9.1%)。病因分析结果显示:糖尿病9例(27.3%),脑干梗死6例(18.2%),脑神经炎3例(9.0%),病毒性脑炎2例(6.1%),痛性眼肌麻痹2例(6.1%),重症肌无力2例(6.1%),颅内动脉瘤2例(6.1%),先天性动眼神经麻痹1例(3.0%),多发性硬化3例(9.1%),病因不明3例(9.1%)。治疗及随访结果:22例(66.7%)患者临床症状完全恢复,包括糖尿病性动眼神经麻痹9例(27.3%),脑干梗死5例(15.2%),脑神经炎3例(9.1%),重症肌无力2例(6.1%),病毒性脑炎2例(6.1%),后交通动脉瘤1例(3.0%)。结论临床上根据动眼神经麻痹患者发病年龄、起病方式、临床症状及相关辅助检查大多数可明确诊断,早期、合理的综合治疗可使大部分患者临床症状改善。Objective To analyze the clinical features and etiology of patients with oculomotor nerve palsy(ONP).Method The clinical data of 33 patients with ONP in the Third Hospital of PLA from Sep 2012 to Dec 2017 were analyzed.Results 33 patients with ONP including monocular involvement in 30 patients(90.9%)and binocular involvement in 3 patients(9.1%).The results of etiological analysis showed that there were 9 cases with diabetes(27.3%),6 cases with brainstem infarction(18.2%),3 cases with cranial neuritis(9.0%),2 cases with viral encephalitis(6.1%),2 cases with painful ophthalmoplegia(6.1%),2 cases with myasthenia gravis(6.1%),2 case with aneurysm(6.1%),1 case with congenital oculomotor palsy(3.0%),3 cases with multiple sclerosis(9.1%),3 cases with unknown cause(9.1%).Follow-up results showed that the clinical symptoms of 22 patients(66.7%)were relieved,including 9 cases of diabetes(27.3%),5 cases of brainstem infarction(15.2%),3 cases of cranial neuritis(9.1%),2 cases of myasthenia gravis(6.1%),2 case of viral encephalitis(6.1%),1 case of posteriorcommunicating artery aneurysm(3.0%).Conclusions The early and accurate diagnosis of ONP should be combined with medical history,clinical manifestations and various auxiliary examination.The symptoms of most patients could improve with early and reasonable comprehensive treatment.

关 键 词：动眼神经麻痹 临床表现 病因 诊断 

分 类 号：R743[医药卫生—神经病学与精神病学]