Moloney Patrick, Hughes Nicola M, Killeen Ronan P, O' Riordan Sean
Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland.
Department of Neuroradiology, St. Vincent's University Hospital, Dublin, Ireland.
Neuroophthalmology. 2018 Oct 26;44(1):28-33. doi: 10.1080/01658107.2018.1534870. eCollection 2020 Feb.
Recurrent painful ophthalmoplegic neuropathy (RPON) replaced the term 'ophthalmoplegic migraine' as the condition behaves more like an inflammatory cranial neuropathy than a primary headache disorder. RPON may be associated with cranial nerve thickening on MR imaging and persistent oculomotor paresis. Oculomotor tumours have rarely been described in cases of relapsing painful ophthalmoplegia with and without persistent paresis. Here, we present a case of relapsing painful left ophthalmoplegia that gradually became persistent. MR imaging after 14 years of symptoms revealed an enhancing tumour of the left oculomotor nerve. It is unclear whether the tumour was the cause of the attacks or whether repeated cycles could lead to tumour development. MR imaging is indicated in patients with RPON who develop persistent deficits to screen for associated oculomotor tumour.
复发性疼痛性眼肌麻痹性神经病（RPON）取代了“眼肌麻痹性偏头痛”这一术语，因为这种病症更像是一种炎性颅神经病变，而非原发性头痛疾病。RPON可能与磁共振成像（MR）上的颅神经增粗以及持续性动眼神经麻痹有关。在伴有或不伴有持续性麻痹的复发性疼痛性眼肌麻痹病例中，动眼神经肿瘤很少被描述。在此，我们报告一例复发性左侧疼痛性眼肌麻痹病例，该病例逐渐发展为持续性。症状出现14年后的MR成像显示左侧动眼神经有一强化肿瘤。尚不清楚该肿瘤是发作的原因，还是反复发会导致肿瘤发生。对于出现持续性功能缺损的RPON患者，建议进行MR成像检查，以筛查相关的动眼神经肿瘤。
