外伤性动眼神经麻痹的临床特点分析

目的总结轻型颅脑损伤所致动眼神经麻痹后的临床特点。方法通过眼外肌运动、眼睑活动、瞳孔大小分析20例轻型颅脑损伤患者动眼神经麻痹的严重程度及功能恢复,随访时间平均为14.2月(3个月~2年)。结果 15名男性患者和5名女性患者纳入此次研究。最常见的外伤原因是交通事故65.4%(13例);眼内肌麻痹是最常见的临床症状;上睑下垂、眼外肌麻痹和眼内肌麻痹的恢复率分别是95%(19例),83.3%(17例)和50%(10例)。结论眼球活动受限是影响轻型颅脑损伤动眼神经麻痹患者生活质量的一个主要因素;蝶骨骨折可能是一个潜在的机制参与了外伤性动眼神经麻痹的发生。

Analysis of clinical features of traumatic oculomotor nerve palsy

Objective To analyze the clinical features of oculomotor nerve palsy following minor head injury. Methods The severity of oculomotor nerve palsy and the functional recovery in 20 patients with minor head injury were evaluated based on extraocular muscle movement, eyelid movement, and the pupil size. The average follow-up period was 14.2 months (ranging from 3 months to 2 years).Results Fifteen male and 5 female patients were recruited to the study. The most common cause of trauma was motor vehicle accident (13 cases, 65.4%). Internal ophthalmoplegia was the most frequently seen clinical symptom. The recovery rates of ptosis, external ophthalmoplegia, and internal ophthalmoplegia were 95%(19 cases), 83.3%(17 cases), and 50%(10 cases), respectively.Conclusions Limitation of eye movements is the major factor that negatively affects the quality of life in patients with oculomotor nerve palsy after minor head injury. Sphenoid bone fracture might be one of the potential mechanisms that trigger the traumatic oculomotor nerve palsy.