眼肌麻痹致眩晕临床分析

目的探讨眼肌麻痹致眩晕患者的病因和临床特点。方法对2010年1月-2013年12月收治的45例眼肌麻痹致眼源性眩晕患者的临床资料进行回顾性分析,并就其致病病因、特点、治疗方法及效果进行总结。结果其病因以眼肌型重症肌无力最多,共20例（44.4%）,其次为Graves眼病,占9例（20.0%）,其他依次为糖尿病性眼肌麻痹5例（11.1%）、颅内炎性疾病4例（8.9%）、内直肌损伤3例（6.7%）、眼眶肿瘤2例（4.4%）和Lambert综合征2例（4.4%）。36例（80.0%）为神经肌肉接头病变或肌肉病变所致,由全身疾病导致的眼肌麻痹（88.9%）比例明显高于眼科局部疾病所致的眼肌麻痹（11.1%）。针对原发疾病进行治疗可获得较好疗效。结论眼源性眩晕病因复杂,非视力所致眼源性眩晕应高度怀疑全身疾病导致的眼肌麻痹。临床应仔细进行相关疾病筛查,并针对原发疾病进行积极治疗。

Clinical Analysis of Vertigo Caused by Ophthalmoplegia

Objective To study the etiology and clinical features of patients with ophthalmoplegia resulting in vertigo. Methods We retrospectively analyzed the clinical data of 45 patients with vertigo caused by ophthamloplegia treated between January 2010 and December 2013. The causes and features of the disease, treatment and outcome were summarized. Results Among the factors responsible for ophthalmoplegia resulting in vertigo, myasthenia gravis（MG） took the first place（20/45, 44.4%）, followed by Graves＇ ophthalmopathy（9/45, 20.0%）, diabetes（5/45, 11.1%）, intracranial infection（4/45, 8.9%）, medial rectus injury（3/45, 6.7%）, orbital tumor（2/45, 4.4%）, and Lambert-Eaton Myasthenic Syndrome（2/45, 4.4%）. In 36 patients, the lesions located in the neuromuscular junction or muscles（80.0%）. The pathogenesis of ophthalmoplegia were almost all caused by systemic diseases（88.9%）, and the occurrence of local ophthalmology diseases was fewer（11.1%）. Etiological treatments achieved beneficial effects. Conclusions The etiology of ophthalmology diseases resulting in vertigo is confusing. We should care more for patients with ophthalmoplegia caused by systemic diseases resulting in ophthalmologic vertigo without vision damage. Careful examinations and proper treatments for etiological factors are necessary in clinical options.