Department of Ophthalmology, Neuro-Ophthalmology Service, "De Gironcoli" Hospital, Conegliano, Italy.
Department of Ophthalmology, "Murri" Hospital, Fermo, Italy.
Surv Ophthalmol. 2019 May-Jun;64(3):433-438. doi: 10.1016/j.survophthal.2017.10.002. Epub 2017 Oct 10.
A 71-year-old woman was admitted with fever, headache, and weight loss associated with elevated inflammatory markers. She developed acute bilateral ophthalmoplegia and asymmetrical ptosis, rapidly followed by anterior ischemic optic neuropathy. Although the first temporal artery biopsy was negative, contralateral temporal artery biopsy revealed features consistent with giant cell arteritis. Even while under steroid therapy, she died a few days later from myocardial infarction. Acute bilateral complete ophthalmoplegia is a rare presentation of a limited number of possible diseases. Among these, giant cell arteritis should be suspected in the appropriate clinical scenario.
一位 71 岁女性因发热、头痛和与炎症标志物升高相关的体重减轻而入院。她出现急性双侧动眼神经麻痹和不对称性上睑下垂，随后迅速出现前部缺血性视神经病变。尽管第一次颞动脉活检为阴性，但对侧颞动脉活检显示符合巨细胞动脉炎的特征。尽管正在接受类固醇治疗，她几天后还是因心肌梗死去世。急性双侧完全动眼神经麻痹是少数几种可能疾病的罕见表现。在这些疾病中，在适当的临床情况下应怀疑为巨细胞动脉炎。
