Yanovitch Tammy, Buckley Edward
Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina 27710, USA.
Curr Opin Ophthalmol. 2007 Sep;18(5):373-8. doi: 10.1097/ICU.0b013e328270b8db.
To provide clinically relevant information regarding the diagnosis, etiology, work-up and treatment of third cranial nerve palsies, while incorporating information from current publications and providing our opinions on these studies.
In the past year, an important study focused on the confirmation of current neuro-imaging guidelines for third cranial nerve palsies. Recent case reports have highlighted etiologies such as giant cell arteritis, trauma, neuro-syphilis and demyelination secondary to infliximab and multiple sclerosis. Surgically, newer studies have focused on globe-tethering procedures for correcting strabismus and the use of frontalis suspension for correcting ptosis. Improved imaging technology with high-resolution magnetic resonance imaging (hr-MRI) allows for direct visualization of the entire nerve path and the affected muscles.
Management of a third nerve palsy depends upon localization of the causative lesion and determination of the underlying etiology. Once these issues are addressed, strabismus surgery can be both challenging and rewarding in these complex patients.
提供有关动眼神经麻痹的诊断、病因、检查及治疗的临床相关信息，同时纳入当前出版物中的信息并给出我们对这些研究的看法。
过去一年，一项重要研究聚焦于动眼神经麻痹当前神经影像学指南的确认。近期病例报告突出了巨细胞动脉炎、创伤、神经梅毒以及英夫利昔单抗和多发性硬化继发的脱髓鞘等病因。在手术方面，新研究集中于用于矫正斜视的眼球固定术以及用于矫正上睑下垂的额肌悬吊术。高分辨率磁共振成像（hr-MRI）等改进的成像技术能够直接观察整个神经路径及受影响的肌肉。
动眼神经麻痹的管理取决于致病病变的定位及潜在病因的确定。一旦解决这些问题，斜视手术对于这些复杂患者而言既具有挑战性又会带来回报。
