Department of Neurology, Chungbuk National University Hospital, Cheongju, South Korea.
Department of Medical Sciences, Neurology, Graduate School of Ajou University, Suwon, South Korea.
Eur J Neurol. 2022 Dec;29(12):3658-3665. doi: 10.1111/ene.15541. Epub 2022 Sep 12.
Trochlear palsy is the most common cause of vertical diplopia. The etiologies of trochlear palsy have shown a large discrepancy among studies. This study aimed to establish the clinical features and underlying etiologies of isolated trochlear palsy by recruiting the patients from all departments in a referral-based university hospital.
We reviewed the medical records of 1258 patients who had a confirmed diagnosis of isolated trochlear palsy at all departments of Seoul National University Bundang Hospital, Seongnam, South Korea, from 2003 to 2020. We also compared the proportion of etiologies with that of the patients pooled from previous studies.
The most common etiology was congenital (n = 330, 32.4%), followed by idiopathic (n = 256, 25.1%), microvascular (n = 212, 20.8%), and traumatic (n = 145, 14.2%). These four etiologies explained 92.5% of isolated trochlear palsy. Patients were mostly managed by ophthalmologists (n = 841, 82.5%), followed by neurologists (n = 380, 37.3%), emergency physicians (n = 197, 19.3%), neurosurgeons (n = 75, 7.4%), and others (n = 18, 1.8%). The etiologic distribution of isolated trochlear palsy in the current study did not differ from that of 2664 patients pooled from the previous studies.
The proportion of etiologies of isolated trochlear palsy differs according to the age ranges of the patients and specialties involved in the management. The etiologic distribution of isolated trochlear palsy in the current study was comparable to the pooled result of previous reports.
滑车神经麻痹是引起垂直复视的最常见原因。滑车神经麻痹的病因在不同研究中存在较大差异。本研究旨在通过在一家以转诊为基础的大学医院的所有科室招募患者，确定孤立性滑车神经麻痹的临床特征和潜在病因。
我们回顾了 2003 年至 2020 年期间在韩国城南盆唐首尔国立大学医院所有科室确诊为孤立性滑车神经麻痹的 1258 例患者的病历。我们还比较了这些病因的比例与以往研究中汇总患者的比例。
最常见的病因是先天性（n=330，32.4%），其次是特发性（n=256，25.1%）、微血管性（n=212，20.8%）和外伤性（n=145，14.2%）。这四种病因解释了 92.5%的孤立性滑车神经麻痹。大多数患者由眼科医生（n=841，82.5%）管理，其次是神经科医生（n=380，37.3%）、急诊医生（n=197，19.3%）、神经外科医生（n=75，7.4%）和其他医生（n=18，1.8%）。本研究中孤立性滑车神经麻痹的病因分布与以往 2664 例患者的汇总结果无差异。
孤立性滑车神经麻痹的病因比例因患者年龄范围和参与治疗的科室不同而有所不同。本研究中孤立性滑车神经麻痹的病因分布与以往报告的汇总结果相似。
