痛性眼肌麻痹综合征的临床分析

目的 探讨痛性眼肌麻痹综合征的病因、临床特点、诊断及治疗。 方法 回顾2000年月至2005年８月所收治的12例痛性眼肌麻痹综合征住院患者的起病情况、临 床表现、实验室检查、影像学检查及治疗，并结合文献进行分析讨论。 结果 12例患者头痛性质、程度等表现多样化。颅神经受累以Ⅲ、Ⅳ、Ⅴ1-2、Ⅵ多见，尤以第Ⅲ颅神经受累最多，占83.3% ，常见几支颅神经同时受累，占75%。诊断需排除其它可引起头痛及眼肌麻痹的疾病。影像学检查可帮助诊断，皮质类固醇激素治疗效果显著，本组治愈率达75%。 结论 痛性眼肌麻痹综合征患者的临床表现、影像学检查以及对皮质类固醇激素治疗反应敏感的特点，均与非特异性炎性肉芽肿之病因相符合。明确诊断后，糖皮质激素治疗有效。 （中华眼底病杂志，2006，22：385-386）

Clinical analysis of the painful ophthalmoplegia syndrome

Objective To detect the clinical manifestations, diagnos is and treatment of painful ophthalmoplegia syndrome. Methods The data of onset, clinical m anifestations, laboratory examination, imaging and treatment from 12 patients with painful ophthalmoplegia, hospitalized from Mar, 2000 to Aug. 2005, were retro spectively analyzed. Results Multiple characters and extents of the headache were found in these 12 patients. The involved cranial nerves included the Ⅲ,Ⅳ, V1-2 and Ⅵ, especially the cranial nerve Ⅲ(83.3%). Several simultaneously in volved cranial nerves were frequently found (75%). Diseases which could cause hea dache along with ophthalmoplegia must be excluded before the diagnosis of the painful ophthalmoplegia syndrome was established. The examination of imaging was important for the diagnosis of painful ophthalmoplegia syndrome. Patients were sensitively responsive to cortico-steoid therapy. The cure rate was 75%. Conclusion The features of clinical manifestations, imaging results and the patients response to cortico-steoid therapy accorded with the etiology of nonspecific inflammation granuloma. Cortico-steoid therapy is effective after the definitude of the disease. (Chin J Ocul Fundus Dis, 2006,22:385-386)