Wiwatwongwana Atchareeya, Lyons Christopher J
Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada; Division of Pediatric Ophthalmology and Strabismus, Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand.
Handb Clin Neurol. 2013;113:1505-13. doi: 10.1016/B978-0-444-59565-2.00021-6.
We review the supranuclear control centers and pathways leading to individual cranial nerve nuclei in the brainstem. We discuss horizontal and vertical gaze and their abnormalities, and review the cranial nerves which subserve eye movements, III, IV, VI, including their clinical testing. We highlight the sites at which these nerves are clinically affected, which often result in characteristic associated features with neurological localizing value. Differential diagnoses of cranial nerve palsies including Duane and Möbius syndromes are also described. Lastly, we discuss the nature of childhood neuromuscular junction disorders such as myasthenia gravis, as well as disorders of the muscle itself (chronic progressive external ophthalmoplegia (CPEO), thyroid orbitopathy).
我们回顾了脑桥中通向各个脑神经核的核上控制中心和通路。我们讨论了水平和垂直凝视及其异常情况,并回顾了支配眼球运动的脑神经,即动眼神经(III)、滑车神经(IV)和展神经(VI),包括它们的临床检查。我们强调了这些神经在临床上受影响的部位,这些部位常常导致具有神经定位价值的特征性相关表现。还描述了包括杜安综合征和莫比乌斯综合征在内的脑神经麻痹的鉴别诊断。最后,我们讨论了儿童期神经肌肉接头疾病(如重症肌无力)以及肌肉本身的疾病(慢性进行性外眼肌麻痹(CPEO)、甲状腺眼病)的性质。