晚年出现的上斜肌麻痹中滑车神经发育不全的影像学表现。
Imaging demonstration of trochlear nerve agenesis in superior oblique palsy emerging during the later life.
作者信息
Lee SeungHa, Kim Sung-Hee, Yang Hee Kyung, Hwang Jeong-Min, Kim Jae Hyoung, Kim Ji-Soo, Park Seong-Ho
机构信息
Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea.
出版信息
Clin Neurol Neurosurg. 2015 Dec;139:269-71. doi: 10.1016/j.clineuro.2015.10.027. Epub 2015 Oct 28.
BACKGROUND
Congenital trochlear palsy may manifest with sudden vertical diplopia due to decompensation during the later life, which may bring a diagnostic challenge.
CASE PRESENTATION
Two men with vertical diplopia for several years after age of 50 were referred with persisting or suddenly aggravating diplopia. Findings were consistent with unilateral superior oblique palsy (SOP) in both patients with a contraversive head tilt. Facial asymmetry was suggestive of a congenital cause in a patient. High resolution magnetic resonance image (MRI)s disclosed atrophic superior oblique and absent trochlear nerve in the side of SOP in both patients.
CONCLUSION
Imaging demonstration of superior oblique atrophy and absent trochlear nerve may aid in diagnosis of congenital SOP presenting sudden vertical diplopia during the later life due to delayed decompensation.
背景
先天性滑车神经麻痹可能在晚年因失代偿而突然出现垂直性复视，这可能带来诊断挑战。
病例报告
两名50岁以后出现数年垂直性复视的男性因持续性或突然加重的复视而前来就诊。两名患者的检查结果均符合单侧上斜肌麻痹（SOP），伴有反向性头位倾斜。一名患者面部不对称提示为先天性病因。高分辨率磁共振成像（MRI）显示两名患者SOP侧的上斜肌萎缩且滑车神经缺如。
结论
上斜肌萎缩及滑车神经缺如的影像学表现有助于诊断因延迟失代偿而在晚年突然出现垂直性复视的先天性SOP。
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