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眼眶肌炎:关于5例新病例临床及影像学特征的评估

Orbital Myositis: Evaluating Five New Cases Regarding Clinical and Radiological Features.

作者信息

Önder Özlem, Bilgin Rıfat Reha, Köşkderelioğlu Aslı, Gedizlioğlu Muhteşem

机构信息

Clinic of Neurology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.

出版信息

Noro Psikiyatr Ars. 2016 Jun;53(2):173-177. doi: 10.5152/npa.2015.10214. Epub 2016 Jun 1.

Abstract

Orbital myositis (OM) is an inflammatory disorder of the extraocular muscles. The signs and symptoms of OM are periorbital pain, eyelid swelling and redness, restricted ocular motility, and strabismus. There are at least two major forms, described by Benedikt GH Schoser, a limited oligosymptomatic ocular myositis (LOOM), which is associated with conjunctival injection only, and severe exophthalmic ocular myositis (SEOM), which presents with additional ptosis, chemosis, and proptosis. We report the clinical and radiological features of five patients with OM who were recently followed in our clinic. Three patients, one man and two women, were placed in the LOOM group, and the other two patients, both women, were in the SEOM group. In both groups, the initial complaints were pain worsening with eye movements and double vision, with only one patient in the SEOM group having pain worsening secondary to Crohn's disease. The most affected muscles were the medial and lateral recti. All the patients were treated with corticosteroids, resulting in rapid improvement. Only one patient in the SEOM group experienced a relapse. Orbital magnetic resonance imaging of all the patients revealed enlargement and contrast enhancement of the involved muscles. Although clinical and radiological features are quite consistent, delayed diagnosis in some patients demonstrates the importance of the awareness of OM.

摘要

眼眶肌炎(OM)是一种眼外肌的炎症性疾病。OM的体征和症状包括眶周疼痛、眼睑肿胀和发红、眼球运动受限以及斜视。至少有两种主要类型,由贝内迪克特·GH·肖泽描述,一种是局限性少症状性眼肌炎(LOOM),仅与结膜充血有关,另一种是严重眼球突出性眼肌炎(SEOM),伴有上睑下垂、结膜水肿和眼球突出。我们报告了最近在我们诊所随访的5例OM患者的临床和影像学特征。3例患者,1名男性和2名女性,被归入LOOM组,另外2例患者,均为女性,被归入SEOM组。两组患者最初的主诉都是眼球运动时疼痛加重和复视,SEOM组只有1例患者因克罗恩病导致疼痛加重。受累最严重的肌肉是内直肌和外直肌。所有患者均接受了皮质类固醇治疗,病情迅速改善。SEOM组只有1例患者复发。所有患者的眼眶磁共振成像均显示受累肌肉增大并强化。尽管临床和影像学特征相当一致,但部分患者的延迟诊断表明了认识OM的重要性。

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