Crompton J L, Burrow D J, Iyer P V
Neuro-ophthalmology Unit, Royal Adelaide Hospital, SA.
Aust N Z J Ophthalmol. 1989 Feb;17(1):71-4. doi: 10.1111/j.1442-9071.1989.tb00489.x.
A 63-year-old man presented six days after the sudden onset of horizontal double vision. His left eye became divergent two days later. On initial examination he had bilateral internuclear ophthalmoplegia with weakness of adduction and abducting nystagmus. Convergence was weak but there were no other neuro-ophthalmic signs. Constitutional signs included confusion and unsteadiness on his feet. A provisional diagnosis of arteritis was made. His ESR was 92 mm/h and a superficial temporal artery biopsy confirmed the diagnosis of giant cell arteritis. After two weeks or oral prednisolone his eye movements returned to normal. There have been no further relapses. This would appear to be a unique presentation of giant cell arteritis. The causes of internuclear ophthalmoplegia are discussed along with a review of the ocular and neuro-ophthalmic signs of giant cell arteritis.
一名63岁男性在突然出现水平性复视6天后前来就诊。两天后他的左眼出现外展。初次检查时，他患有双侧核间性眼肌麻痹，伴有内收无力和外展性眼球震颤。集合功能较弱，但无其他神经眼科体征。全身症状包括意识模糊和行走不稳。初步诊断为动脉炎。他的血沉为92毫米/小时，颞浅动脉活检确诊为巨细胞动脉炎。口服泼尼松龙两周后，他的眼球运动恢复正常。此后未再复发。这似乎是巨细胞动脉炎的一种独特表现。本文讨论了核间性眼肌麻痹的病因，并对巨细胞动脉炎的眼部和神经眼科体征进行了综述。
