Ogun Olufunmilola A, Aremu Olalekan O, Ajaiyeoba Ayotunde I
Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Ophthalmology, University College Hospital, Ibadan, Nigeria.
Neuroophthalmology. 2019 Jan 30;43(6):355-362. doi: 10.1080/01658107.2019.1566829. eCollection 2019 Dec.
The aim of this article from Nigeria is to draw attention to public health issues in medical care using ocular motor cranial nerve palsy (OMCNP) presenting to a neuro-ophthalmology clinic as a case study. All patients presenting with OMCNP between November 2007 and October 2016 were retrospectively reviewed. Demographic details as well as information regarding the clinical presentation, clinical course, investigation, and treatment outcomes were extracted from case records. Phone calls were made to the contact numbers of patients who had been lost to follow-up. Data were analysed using SPSS version 22 (IBM, Corp. Armonk, NY, USA). Cranial nerve palsies other than oculomotor, trochlear, and abducens palsies were excluded. Fifty-nine patients, comprising 28 males and 31 females, were identified. Age range was 1-84 years (median 43.0 ± 19.7 years). Fifty-one cases (93.2%) were mono neuropathies, while four (6.8%) affected multiple nerves. Oculomotor nerve palsy was most common, accounting for 57.6% of cases. Microvascular angiopathy was the commonest identifiable cause (25.6%). Aetiology was not identified in 16 cases. There were three (5.1%) deaths. Undiagnosed systemic disease appears to be a major risk factor for this patient group in this African setting. Patient investigation was problematic. Poor patient compliance and follow-up resulted in preventable deaths. Neuro-ophthalmologists practicing in low resource settings should be aware of these risks.
这篇来自尼日利亚的文章旨在以一家神经眼科诊所接诊的动眼神经颅神经麻痹（OMCNP）为例，提请人们关注医疗保健中的公共卫生问题。对2007年11月至2016年10月期间所有出现OMCNP的患者进行了回顾性研究。从病例记录中提取了人口统计学细节以及有关临床表现、临床病程、检查和治疗结果的信息。致电了失访患者的联系电话。使用SPSS 22版（美国纽约州阿蒙克市IBM公司）对数据进行分析。排除动眼神经、滑车神经和展神经麻痹以外的颅神经麻痹。共确定了59例患者，其中男性28例，女性31例。年龄范围为1至84岁（中位数43.0±19.7岁）。51例（93.2%）为单神经病，4例（6.8%）累及多条神经。动眼神经麻痹最为常见，占病例的57.6%。微血管病变是最常见的可识别病因（25.6%）。16例未明确病因。有3例（5.1%）死亡。在这种非洲环境下，未诊断出的全身性疾病似乎是该患者群体的主要危险因素。患者检查存在问题。患者依从性差和随访不力导致了可预防的死亡。在资源匮乏地区执业的神经眼科医生应意识到这些风险。
