Oo Kok-Tian, Tay Kim-Siang, Law Wan-Chung, Shatriah Ismail
Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Department of Neuromedicine, Hospital Umum Sarawak, Jalan Hospital, Kuching, Sarawak, Malaysia.
Taiwan J Ophthalmol. 2019 Dec 5;10(3):235-238. doi: 10.4103/tjo.tjo_69_19. eCollection 2020 Jul-Sep.
Over the past decade, the discovery of disease-specific aquaporin-4 antibodies has led to a better understanding of the diverse spectrum of disorders that are associated with neuromyelitis optica. Brainstem manifestations have been increasingly recognized in this disease. However, multiple cranial nerve palsies as an initial presentation of neuromyelitis optica are uncommon. We report a rare case of anti-aquaporin-4 antibody-positive neuromyelitis optica that presented with unilateral abducens and facial nerve palsies. Notably, this case did not involve the optic nerve or the spinal cord. Diagnosing neuromyelitis optica that presents as an isolated acute brainstem syndrome is challenging, but the outcome may be devastating if the diagnosis is delayed.
在过去十年中，疾病特异性水通道蛋白4抗体的发现使人们对与视神经脊髓炎相关的各种疾病有了更好的理解。脑干表现在此疾病中越来越受到认可。然而，以多发性颅神经麻痹作为视神经脊髓炎的初始表现并不常见。我们报告了一例罕见的抗水通道蛋白4抗体阳性的视神经脊髓炎，其表现为单侧展神经和面神经麻痹。值得注意的是，该病例未累及视神经或脊髓。诊断表现为孤立性急性脑干综合征的视神经脊髓炎具有挑战性，但如果诊断延迟，后果可能是毁灭性的。
