Aoki Yoshihiro, Hashimoto Takao
Department of Emergency and Critical Care Medicine, Aizawa Hospital, Matsumoto, Japan.
Department of Neurology, Aizawa Hospital, Matsumoto, Japan.
Case Rep Neurol. 2022 Apr 4;14(1):197-201. doi: 10.1159/000523986. eCollection 2022 Jan-Apr.
We report a case of bilateral ptosis due to paramedian midbrain infarction, which was associated with ipsilateral impaired adduction of the eye and contralateral ataxia. T2-weighted magnetic resonance imaging of the brain revealed a right paramedian midbrain infarction. The ptosis rapidly improved without a difference between the left and right sides, while the other symptoms mostly resolved within a month following treatment with antiplatelet agents and rehabilitation. An infarction of the paramedian dorsocaudal portion of the midbrain can involve both the central caudal nucleus and the median longitudinal fasciculus (MLF), causing a peculiar combination of symptoms, bilateral ptosis, and unilateral MLF syndrome.
我们报告一例因中脑旁正中梗死导致的双侧上睑下垂病例，该病例伴有同侧眼球内收障碍和对侧共济失调。脑部T2加权磁共振成像显示右侧中脑旁正中梗死。上睑下垂迅速改善，左右两侧无差异，而其他症状在使用抗血小板药物和康复治疗后一个月内大多得到缓解。中脑背尾侧旁正中部分梗死可累及中央尾状核和内侧纵束（MLF），导致双侧上睑下垂和单侧MLF综合征等特殊症状组合。
