Berlit P
Mannheim Neurological Clinic, University of Heidelberg, F.R.G.
J Neurol Sci. 1991 May;103(1):10-5. doi: 10.1016/0022-510x(91)90276-d.
We evaluated the hospital records of 412 patients with isolated or combined ocular nerve palsies in a retrospective study. Palsies of the oculomotor nerve (n = 172) and of the abducens nerve (n = 165) were more frequent than those of the trochlear nerve (n = 25). Combined ocular nerve palsies (n = 50) were generally combinations of the 3rd and 6th cranial nerves (n = 21) or pareses of all three ocular nerves (n = 17). 165 ocular nerve palsies were due to vascular causes: in 135 of these cases diabetes mellitus and hypertension were present. The oculomotor nerve was most frequently affected; in 63% there was no involvement of the pupil. In inflammatory disease and brain tumor the abducens nerve was most frequently affected, with aneurysm of the oculomotor nerve. The origin of ophthalmoplegia was unclear in 73 patients. Ocular nerve paralysis was most common with tumors, aneurysm, and vascular processes and in 206 cases was only partial. Pain was associated with tumor, trauma and aneurysm. In trochlear nerve palsies concomitant pain was much less frequent than in palsies of the other two ocular nerves. The clinical course was followed for 3 weeks in 352 patients; in 191 patients there was a complete regression of the pareses and in 59 only a partial recovery. The most favorable prognosis was with inflammatory and vascular lesions; in the latter the outcome was improved by the administration of non-steroidal anti-inflammatory drugs.
在一项回顾性研究中，我们评估了412例孤立性或合并性动眼神经麻痹患者的医院记录。动眼神经麻痹（n = 172）和外展神经麻痹（n = 165）比滑车神经麻痹（n = 25）更常见。合并性动眼神经麻痹（n = 50）通常是第3和第6颅神经的合并（n = 21）或所有三条动眼神经的麻痹（n = 17）。165例动眼神经麻痹是由血管原因引起的：其中135例存在糖尿病和高血压。动眼神经最常受累；其中63%的病例瞳孔未受累。在炎症性疾病和脑肿瘤中，外展神经最常受累，动眼神经有动脉瘤。73例患者的眼肌麻痹病因不明。动眼神经麻痹在肿瘤、动脉瘤和血管病变中最常见，206例仅为部分麻痹。疼痛与肿瘤、创伤和动脉瘤有关。在滑车神经麻痹中，伴随疼痛比其他两条动眼神经麻痹时少见得多。352例患者的临床病程随访了3周；191例患者的麻痹完全消退，59例仅部分恢复。最有利的预后是炎症性和血管性病变；在血管性病变中，使用非甾体抗炎药可改善预后。
