Baylor College of Medicine (NR, AGL), Houston, Texas; Department of Ophthalmology (PM, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; The Houston Methodist Research Institute (AGL), Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology (AGL), Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York; and Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas.
J Neuroophthalmol. 2021 Sep 1;41(3):e372-e374. doi: 10.1097/WNO.0000000000001188.
The most common etiology of an isolated abducens nerve palsy in an older adult with vasculopathic risk factors is presumed microvascular ischemia. Because the diagnosis of microvascular ischemia in this setting would not alter patient management, there is debate as to whether further workup is warranted under these circumstances. In this report, we describe a fascicular sixth nerve palsy as the initial presenting sign of metastatic ovarian carcinoma, and we highlight the importance of considering additional workup in select cases of isolated abducens nerve palsies.
在有血管病变风险因素的老年患者中，孤立性展神经麻痹最常见的病因是推测性微血管缺血。由于在这种情况下微血管缺血的诊断不会改变患者的治疗方法，因此对于在这些情况下是否需要进一步检查存在争议。在本报告中，我们描述了 1 例神经束性第六脑神经麻痹作为转移性卵巢癌的初始表现，并强调了在选择孤立性展神经麻痹病例中进行额外检查的重要性。
