63例Tolosa-Hunt综合征临床分析

目的 探讨Tolosa-Hunt综合征(THs)的诊断、鉴别诊断及治疗,以提高该病的诊疗水平.方法 回顾性研究1996.2006年临床确诊的63例THS,分析其临床特点、实验室检查、影像学表现、治疗效果及预后.结果 63例患者中多为急性、亚急性起病,均有头痛和眼肌麻痹,大多数以动眼神经损伤为主,部分呈动眼神经完全损伤,Ⅲ、Ⅳ、Ⅵ颅神经同时受累较多见,可伴有视神经损伤,经CT、MRI排除其他疾病,激素治疗有效.结论 痛性眼肌麻痹综合征可能因非特异性炎症引起,相关实验室检查、影像学检查有一定价值,激素治疗敏感.

Clinical analysis of 63 patients with Tolosa-hunt syndrome

Objective To investigate the diagnosis, differential diagnosis and treatment of Tolosa-hunt syndrome and to improve the diagnosis and treatment ability of this diseases. Methods Sixty-three patients clinically diagnosised Tolosa-hunt syndrome from 1996 to 2006 were studied retrospectively and its clinical characteristics, laboratory examinations, imaging appearances, therapeutic efficecies and prognosis were analyzed. Results Most of the cases in 63 patients are acute and subacute onset, accompanied by headache and ophthalmoplegia. Among ophthalmoplegia, most patients have oculomotor nerve paralysis and some are completely paralysis. Patients with concurrent third, fourth and sixth cranial nerves involvement are very common. In some patients optic nerve involvement can be found. CT and MRI examination can be used to rule out other diseases. Steroid is effective in the treatement of this disease. Conclusion Tolosa-hunt syndrome may be caused by non-specific inflammation of orbital tissue. Relevant laboratory and imaging examinations are valuable in the diagnosis of this disease and steroid is effective in its treatment.