老年人眼外肌麻痹的原因分析

目的探讨老年人眼外肌麻痹的临床病因及特点。方法对113例以复视为首发症状的眼外肌麻痹患者的临床资料进行回顾性研究,依据病史、临床检查分析发病原因,并对其进行相关治疗。结果眼外肌麻痹的发病部位以核性及核下性眼球运动障碍为主,占83．19％。发病原因以血管性疾病为主,占49．56％。受累部位以动眼神经麻痹占首位为36．28％外展神经麻痹次之,占30．09％。单条眼外肌麻痹较多条肌肉麻痹多见,其中以内直肌受累居多。结论以复视为首发症状的老年人眼外肌麻痹多见,其中以内直肌受累居多。结论以复视为首发症状的老年人眼外肌麻痹病因复杂,以血管性疾病多见,以核及核下性损害为主,动眼神经麻痹占首位。必须及早检查,明确诊断,并给予相关治疗,以免误诊,应引起重视。

Factor analysis of external ophthalmoplegia in senior patients

Objective To analyze the causes and features of external ophthalmoplegia in senior patients. Methods A retrospective study was made on the medical charts of 113 patients of external ophthalmoplegia, with diplopia as initial symptom. The causes were assessed according to the medical histories and clinical examinations. Resutls The major impairment were nuclear and subnuclear ocular movements, accounting for 83.19%. The major causes were vascular diseases, accounting for 49.56%. Paralysis of oculomotor nerve accounted for 36.28% of the primary affected region. Paralysis of abducens nerve accounted for 30.09%. Paralysis of single extraocular muscle was more common than paralyses of multiple extraocular muscles, affecting medial rectus muscle more frequently than others. Conclusion The causes of external ophthalmoplegia in senior patients who developed diplopia as initial symptom were multi-factored, which were mostly due to vascular diseases with primarily nuclear and subnuclear damages and paralysis of oculomotor nerve. Patients were suggested to have early examination, diagnosis and treatment to avoid misdiagnosis.