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钝性创伤后孤立性神经源性上睑下垂的自发缓解:一例报告及文献综述

Spontaneous resolution of isolated neurogenic blepharoptosis after blunt trauma: A case report and literature review.

作者信息

Kim Tae Gi, Shin Jae Ho

机构信息

Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, Korea.

出版信息

Medicine (Baltimore). 2018 Nov;97(44):e12988. doi: 10.1097/MD.0000000000012988.

Abstract

RATIONALE

Complete isolated neurogenic blepharoptosis caused by blunt trauma is a sporadically reported rare entity and there is no consensus regarding the optimal treatment. We would like to report a rare case of isolated neurogenic blepharoptosis secondary to eyelid trauma with spontaneous recovery occurring within 4 weeks.

PATIENT CONCERNS

A previously healthy 47-year-old man presented with blepharoptosis in the right eye after eyelid trauma.

DIAGNOSIS

At presentation, visual acuity in both eyes was 20/20, and intraocular pressure was within the normal limits. Physical examination showed unilateral ptosis; magnetic resonance imaging (MRI) showed hematoma in the right frontal sinus. No intracranial lesions were observed and the pupillary reactions were normal. The remainder of the examination was unremarkable with full ocular motility. He was diagnosed with an isolated neurogenic blepharoptosis.

INTERVENTION AND OUTCOMES

He was managed conservatively without any specific treatment. Four weeks later, the patient had normal, symmetric lid height, and levator function was completely restored.

LESSONS

Isolated neurogenic blepharoptosis can be caused by blunt trauma, which might cause injury to the terminal branch of the oculomotor nerve. In this case, no special treatment was required, and complete resolution was achieved within 4 weeks.

摘要

理论依据

钝器伤导致的完全性孤立性神经源性上睑下垂是一种罕见病例,仅有零星报道,对于最佳治疗方法尚无共识。我们报告一例罕见的因眼睑外伤继发的孤立性神经源性上睑下垂病例,该病例在4周内自发恢复。

患者情况

一名47岁既往健康男性在眼睑外伤后出现右眼上睑下垂。

诊断

就诊时,双眼视力均为20/20,眼压在正常范围内。体格检查显示单侧上睑下垂;磁共振成像(MRI)显示右侧额窦有血肿。未观察到颅内病变,瞳孔反应正常。其余检查无异常,眼球活动正常。他被诊断为孤立性神经源性上睑下垂。

干预措施及结果

对其进行保守治疗,未采取任何特殊治疗。4周后,患者上睑高度恢复正常且对称,提上睑肌功能完全恢复。

经验教训

孤立性神经源性上睑下垂可由钝器伤引起,钝器伤可能损伤动眼神经终末分支。在此病例中,无需特殊治疗,4周内完全恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40ac/6221630/e8dd0981561e/medi-97-e12988-g001.jpg

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