痛性眼肌麻痹的临床分析.doc

痛性眼肌麻痹的临床分析.doc痛性眼肌麻痹的临床分析
山东省烟台市市直机关医院内科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对颅祌经同时受累较多,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
痛性眼肌麻痹乂称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
Tolosa(l)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。
1.—般资料:共9例,苏中男性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吋间情况:现痛后麻痹7例(吋间1-15天不等,其中第一周5例,第二周2例),同时