Alcubierre Rafel, Alejaldre Aida
Department of Ophthalmology, Hospital Moisès Broggi Sant Joan Despi, Consorci Sanitari Integral, Barcelona, Spain.
Department of Neurology, Hospital Moisès Broggi Sant Joan Despi, Consorci Sanitari Integral, Barcelona, Spain.
J AAPOS. 2020 Oct;24(5):298-298.e1. doi: 10.1016/j.jaapos.2020.03.014. Epub 2020 Oct 13.
Ocular neuromyotonia is a rare disorder of the oculomotor nerves caused by chronic damage to the nerve, usually secondary to previous irradiation or longstanding compression. We present the case of a 40-year-old man who had received proton beam therapy for a right cavernous sinus chondrosarcoma 15 years earlier. He developed intermittent episodes of self-limited horizontal diplopia, which occurred over the course of 1 year. At its peak, the deviation reached 20 in primary gaze and 25 in right gaze. Signs included right upper lid retraction and right medial rectus muscle absence of relaxation after sustained left gaze, with mild deficit of elevation and depression but no pupillary involvement. Full recovery occurred after he closed his eyes. Ocular neuromyotonia of the right oculomotor nerve was diagnosed after recurrence of primary disease relapse was ruled out. Symptoms remitted completely under oxcarbazepine.
眼肌神经性肌强直是一种由神经慢性损伤引起的动眼神经罕见疾病，通常继发于既往放疗或长期受压。我们报告一例40岁男性病例，该患者15年前因右侧海绵窦软骨肉瘤接受了质子束治疗。他出现了间歇性自限性水平复视，病程持续1年。在高峰期，原在位时斜视度达到20三棱镜度，右侧注视时达到25三棱镜度。体征包括右上睑退缩，持续向左注视后右侧内直肌无松弛，伴有轻度上抬和下转功能障碍，但瞳孔未受累。闭眼后完全恢复。排除原发性疾病复发后，诊断为右侧动眼神经眼肌神经性肌强直。在奥卡西平治疗下症状完全缓解。
