Lee Michael S, Egan Robert A, Shults William T, Lessell Simmons
Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota 55455, USA.
Ophthalmology. 2005 Dec;112(12):2225-6. doi: 10.1016/j.ophtha.2005.09.008.
To describe a unique idiopathic disorder characterized by transient repetitive unilateral oculomotor pareses.
Retrospective observational case series.
Three women presenting for tertiary neuro-ophthalmologic evaluation.
Review of patient records.
Historical information, clinical examination, neuroimaging, and laboratory evaluation for myasthenia gravis.
Three 44- to 69-year-old women had recurrent unilateral ptosis over the course of 2 to 4 years. Two had concurrent diplopia with ipsilateral limitation of adduction, and 2 also had a large poorly reactive pupil in the involved eye during the episodes. The attacks lasted between 30 seconds and 4 hours and occurred up to 6 times daily. None of the patients were migraineurs, nor had they received radiation therapy. Neuro-ophthalmologically normal between episodes, all patients had normal magnetic resonance imaging/angiography and testing for myasthenia gravis.
Transient, recurrent, unilateral oculomotor nerve palsies may occur spontaneously in healthy individuals. The pathogenesis remains obscure, but the multiple recurrences without evident sequelae and the failure to develop any systemic or neurological disorder suggest that this phenomenon is not indicative of a serious underlying disorder.
描述一种以短暂性重复性单侧动眼神经麻痹为特征的独特特发性疾病。
回顾性观察病例系列。
三名前来接受三级神经眼科评估的女性。
查阅患者病历。
重症肌无力的病史信息、临床检查、神经影像学及实验室评估。
三名44至69岁的女性在2至4年的病程中反复出现单侧上睑下垂。其中两名患者同时伴有复视及同侧内收受限，且在发作期间，两名患者受累眼还出现瞳孔散大、对光反应迟钝。发作持续30秒至4小时，每天发作多达6次。所有患者均无偏头痛病史，也未接受过放射治疗。发作间期神经眼科检查正常，所有患者的磁共振成像/血管造影及重症肌无力检测均正常。
健康个体可自发出现短暂性、复发性、单侧动眼神经麻痹。其发病机制尚不清楚，但多次复发且无明显后遗症，也未发展为任何全身性或神经系统疾病，提示这种现象并非严重潜在疾病的指征。
