痛性眼肌麻痹的研究进展

痛性眼肌麻痹综合征（painful ophthamoplegia syndrome）亦称Tolosa-Hunt综合征（THS）,是一种缓解和复发的一侧Ⅲ,Ⅳ,Ⅵ脑神经之一或同时受累,从而造成眼肌麻痹,并伴有眼眶部疼痛的一组症候群。其病因不明,可能为免疫缺陷性反应,也有学者认为其是眶上裂的非特异性炎症或与血管性病变有关。该病依神经受影响之范围大小、程度轻重,其眼部症状有各种表现。痛性眼肌麻痹综合征在临床上少见,易与眼肌麻痹性头痛相混淆,临床诊断有一定的困难,治疗上对肾上腺皮质激素有效。本文旨在对痛性眼肌麻痹综合征的病因、临床特点、诊断、鉴别诊断和治疗进行综述如下。

Advance in the diagnosis and treatment of painful ophthalmoplegia syndrome

Painful ophthalmoplegia syndrome, the Tolosa-Hunt syndrome(THS), is characterized by unilateral involvement of the IIIrd, IVth and VIth cranial nerves, as well as supra- and retro-orbital pain. The etiology is unknown, possibly related to immunodeficiency reaction, also, some scholars believe that it is related with non-specific inflammation of the superior orbital fissure or vascular lesions. The ocular symptoms vary depending on the scope, impact and severity degree of the nerve. Painful ophthalmoplegia syndrome is rare in clinic and easily misdiagnosed as ophthalmoplegic headache. Clinical diagnosis is difficult, while adrenal cortical hormone is effective in treatment. We made a review on the etiology, clinical characteristics, diagnosis, differential diagnosis and treatment of painful ophthalmoplegia syndrome.