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神经病学中的眼睛:突发视力丧失和复视的评估——诊断要点与陷阱

The eye in neurology: evaluation of sudden visual loss and diplopia--diagnostic pointers and pitfalls.

作者信息

Loong S C

机构信息

Division of Medicine, National University of Singapore.

出版信息

Ann Acad Med Singap. 2001 Mar;30(2):143-7.

Abstract

The evaluation of sudden visual loss should begin with the differentiation between monocular loss and binocular loss. The importance of this is reflected in the differences between the main causes of monocular and binocular losses. In cases of transient monocular visual loss, an ocular cause has to be kept in mind so as to avoid unnecessary and costly cerebrovascular investigations. In cases of persistent monocular visual loss, a compressive lesion of the optic nerve or chiasma may simulate optic neuritis. In the evaluation of diplopia, the main differential diagnoses are nerve lesions and myasthenia. The main causes of nerve lesions responsible for diplopia and their workup are summarised. The usefulness of eye signs in the diagnosis of myasthenia is highlighted. The possibility of compressive lesions co-existing with or masquerading as myasthenia is emphasised.

摘要

对突然视力丧失的评估应从区分单眼视力丧失和双眼视力丧失开始。这一点的重要性体现在单眼和双眼视力丧失的主要病因差异上。在短暂性单眼视力丧失的病例中,必须考虑眼部病因,以避免不必要且昂贵的脑血管检查。在持续性单眼视力丧失的病例中,视神经或视交叉的压迫性病变可能会模拟视神经炎。在复视的评估中,主要的鉴别诊断是神经病变和重症肌无力。总结了导致复视的神经病变的主要病因及其检查方法。强调了眼部体征在重症肌无力诊断中的作用。同时强调了压迫性病变与重症肌无力并存或伪装成重症肌无力的可能性。

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