Hyland Sara J, Kavi Tapan R, Smith Nicole R, Lin Jacky, Catton Mark D
Department of Pharmacy, OhioHealth Grant Medical Center, Columbus, USA.
Department of Neurocritical Care, OhioHealth Riverside Methodist Hospital, Columbus, USA.
Cureus. 2021 Oct 15;13(10):e18802. doi: 10.7759/cureus.18802. eCollection 2021 Oct.
A 58-year-old woman was found to have bilateral ptosis and downward gaze deviation immediately after elective shoulder surgery with general anesthesia and supraclavicular nerve block. A code stroke was activated due to concern for the neurologic process, but neuroimaging did not reveal acute changes or vascular abnormality. Her symptoms gradually resolved in the following hours with supportive care and were ultimately deemed to be related to anesthetic and transdermal scopolamine exposures layered upon her underlying comorbidities. Transient bilateral ophthalmoplegia after general anesthetics has been previously described; drug effect should be considered in the differential of this alarming presentation, which can mimic acute stroke and/or Horner syndrome.
一名58岁女性在择期肩部手术接受全身麻醉和锁骨上神经阻滞后，立即出现双侧上睑下垂和向下凝视偏斜。由于担心神经系统病变，启动了卒中急救流程，但神经影像学检查未发现急性变化或血管异常。在接下来的几个小时里，她的症状在支持治疗下逐渐缓解，最终被认为与麻醉药和透皮东莨菪碱暴露叠加其基础合并症有关。全身麻醉后出现短暂性双侧眼肌麻痹此前已有报道；在鉴别这种可模拟急性卒中和/或霍纳综合征的警示性表现时，应考虑药物作用。
