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引起视神经孔综合征的眼外肌囊尾蚴病的外科治疗

Surgical Management of Extraocular Muscle Cysticercosis Causing Optic Foramen Syndrome.

作者信息

Patidar Rajnish Kumar, Bhaskar Suryanarayanan, Gosal Jaskaran Singh, Garg Mayank, Jha Deepak Kumar, Elhence Poonam

机构信息

Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

出版信息

Asian J Neurosurg. 2020 Feb 25;15(1):165-167. doi: 10.4103/ajns.AJNS_280_19. eCollection 2020 Jan-Mar.

Abstract

Extraocular muscle cysticercosis usually presents with proptosis and restriction of eyeball movements. However, it can cause vision loss by compression of the optic nerve at the optic foramen in infrequent circumstances. We report a rare case with an unusual manifestation of ptosis, proptosis, lateral rectus palsy, and acute vision loss in the right eye. Magnetic resonance imaging was suggestive of cysticercal cyst. Emergency optic nerve decompression with cyst excision was done. Treatment of choice for extraocular muscle cysticercosis presenting with restriction of eyeball movements is mainly medical, consisting of albendazole and steroids. However, as this lesion rarely causes vision loss, indications of surgical decompression of optic nerve are not well defined. We recommend that early surgical management should be done along with medical treatment in cases of vision loss caused by extraocular muscle cysticercosis.

摘要

眼外肌囊尾蚴病通常表现为眼球突出和眼球运动受限。然而,在罕见情况下,它可通过压迫视神经孔处的视神经导致视力丧失。我们报告一例罕见病例,其表现为上睑下垂、眼球突出、外直肌麻痹和右眼急性视力丧失等不寻常症状。磁共振成像提示为囊尾蚴囊肿。遂进行了急诊视神经减压并切除囊肿。对于表现为眼球运动受限的眼外肌囊尾蚴病,主要治疗方法是药物治疗,包括使用阿苯达唑和类固醇。然而,由于这种病变很少导致视力丧失,视神经手术减压的指征尚不明确。我们建议,对于由眼外肌囊尾蚴病导致视力丧失的病例,应在药物治疗的同时尽早进行手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c148/7057861/65c41869c741/AJNS-15-165-g001.jpg

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