Department of Neurology, Aizawa Hospital, 2-5-1 Honjo, Matsumoto 390-8510, Japan.
J Clin Neurosci. 2011 Sep;18(9):1256-8. doi: 10.1016/j.jocn.2010.12.044. Epub 2011 Jul 2.
We report two patients with diffuse large B-cell lymphoma with isolated oculomotor nerve palsy. This was the initial manifestation of lymphoma in one patient but in a second, the palsy appeared as a part of a generalized recurrence of lymphoma. In addition, we reviewed the clinical findings of 12 previously reported patients. Isolated oculomotor nerve palsy was most frequently associated with the large B-cell lymphoma cell type, and was not frequently associated with periorbital pain. The pupil was spared in half the patients irrespective of infiltration of the oculomotor nerve. MRI and cerebrospinal fluid cytological examinations are helpful in determining invasion of lymphoma to the oculomotor nerve, cavernous sinus, and surrounding leptomeninges.
我们报告了两例伴有孤立性动眼神经麻痹的弥漫性大 B 细胞淋巴瘤患者。在一例患者中，这是淋巴瘤的初始表现，但在另一例患者中，麻痹是作为淋巴瘤全身性复发的一部分出现的。此外，我们复习了 12 例既往报道患者的临床资料。孤立性动眼神经麻痹最常与大 B 细胞淋巴瘤细胞类型相关，并且与眶周疼痛不常相关。无论动眼神经是否受到浸润，一半的患者瞳孔都不受影响。MRI 和脑脊液细胞学检查有助于确定淋巴瘤对动眼神经、海绵窦和周围软脑膜的侵犯。
