痛性眼肌麻痹的临床分析.doc

痛性眼肌麻痹的临床分析
264000; 265300
摘要:目的总结9例痛性眼肌麻痹(THS)患者的临床资料。方法对患者的发病年龄、季节、性别、起病形式、颅神经受损、眼肌麻痹、实验室检查及激素疗效进行观察、分析、讨论。结果发病季节和性别无明显差异,头痛先于眼肌麻痹者为多,第Ⅲ、Ⅳ对颅神经同时受累较多,实验室和MRI、CT检查无异常发现,皮质类固醇治疗有效。结论痛性眼肌麻痹是一种排除性诊断,皮质类固醇治疗后眼部症状缓解最迟需三个月,故不宜过早停药。
关键词:痛性眼肌麻痹;临床分析
Abstract Objective To summarize clinical material of 13 caseof Tolosa-Hunt syndrome Methods We observed,analyzed,and discussed their age,sex,the seasons and modes of onset,involvement of the cranial nerves,ophthalmonplegia,laboratory investigation,and response to As for the seasons of disease and sex of patients there is no difference;most patients had headache before ophthalmoplegia and involved the Ⅲ、Ⅳ cranial nerves at the same time;there was no special discovery in laboratory,MRI and CT investigation;corticosteroid is effective..Conclusion The diagnosis of painful ophthalmoplegia is takes no more than 3 months after corticosteroid treatment for ophthalmoplegia to be improved,so the treatment should not be stopped too early.
Key words Tolosa-Hunt syndrome clinical study

痛性眼肌麻痹又称 Tolosa-Hunt 综合征(THS),是一种伴有头痛和眼肌麻痹的特发性眼眶和海绵窦炎性疾病,临床上较少见,且病因多样,容易误诊。由
Tolosa⑴和Hunt⑵等首先报道。国内自1979年以来有少量的报道。现将我院2005年至今所收治的13例病例的临床资料进行分析。
:共9例,其中男性4例,女性5例。发病年龄41-73岁,,其中40-50岁4例,50-60岁1例,60-70岁2例,70岁以上2例。头痛与眼部症状出现时间情况:现痛后麻痹7例(时间1-15天不等,其中第一周5例,第二周2例),同时出现1例,先麻痹后疼痛1例,且间隔时