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因琐事而忽略了重要之事:慢性进行性外眼肌麻痹合并单侧面神经损伤:一例报告及文献综述

Have one's view of the important overshadowed by the trivial: chronic progressive external ophthalmoplegia combined with unilateral facial nerve injury: a case report and literature review.

作者信息

Feng Ziyang, Lai Rui, Wei Jia, Liu Xuan, Chen Xueqin, Liu Yangsicheng, Qin Wenxin, Qin Xiude, Kong Fanxin

机构信息

The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China.

School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

出版信息

Front Neurol. 2024 Jan 5;14:1268053. doi: 10.3389/fneur.2023.1268053. eCollection 2023.

Abstract

Chronic progressive external ophthalmoplegia (CPEO) is a mitochondrial encephalomyopathy that is characterized by progressive ptosis and impaired ocular motility. Owing to its nonspecific clinical manifestations, CPEO is often misdiagnosed as other conditions. Herein, we present the case of a 34-year-old woman who primarily presented with incomplete left eyelid closure and limited bilateral eye movements. During the 6-year disease course, she was diagnosed with myasthenia gravis and cranial polyneuritis. Finally, skeletal muscle tissue biopsy confirmed the diagnosis. Biopsy revealed pathological changes in mitochondrial myopathy. Furthermore, mitochondrial gene testing of the skeletal muscle revealed a single chrmM:8469-13447 deletion. In addition, we summarized the findings of 26 patients with CPEO/Kearns-Sayre syndrome who were misdiagnosed with other diseases owing to ocular symptoms. In conclusion, we reported a rare clinical case and emphasized the symptomatic diversity of CPEO. Furthermore, we provided a brief review of the diagnosis and differential diagnosis of the disease.

摘要

慢性进行性眼外肌麻痹(CPEO)是一种线粒体脑肌病,其特征为进行性上睑下垂和眼球运动障碍。由于其临床表现缺乏特异性,CPEO常被误诊为其他疾病。在此,我们报告一例34岁女性患者,其主要表现为左侧眼睑闭合不全和双侧眼球运动受限。在6年的病程中,她先后被诊断为重症肌无力和颅神经炎。最终,骨骼肌组织活检确诊了病情。活检显示出线粒体肌病的病理改变。此外,对骨骼肌进行的线粒体基因检测发现了一个单一的线粒体DNA:8469-13447缺失。另外,我们总结了26例因眼部症状被误诊为其他疾病的CPEO/卡恩斯-塞尔综合征患者的检查结果。总之,我们报告了一例罕见的临床病例,并强调了CPEO症状的多样性。此外,我们还对该疾病的诊断和鉴别诊断进行了简要综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d73b/10797034/35a59c1265d5/fneur-14-1268053-g0001.jpg

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