The College of Clinical Medicine 2, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China.
The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China.
Medicine (Baltimore). 2024 Aug 2;103(31):e39144. doi: 10.1097/MD.0000000000039144.
Sudden ocular dyskinesia is usually associated with ophthalmic diseases and rarely with cerebrovascular diseases. This is a rare case of a patient with a sudden onset of ocular dyskinesia due to occlusion of the anterior inferior cerebellar artery and the spiral modiolar artery. This article describes eye movement disorders associated with cerebrovascular disease, aiming to improve our understanding of cerebrovascular diseases and improve the ability of early diagnosis and differential diagnosis.
A 52-year-old man presented with acute pontine cerebral infarction 2 days before presentation. The main symptoms were the inability to adduct and abduct the left eyeball, the ability to abduct but not adduct the right eyeball, and horizontal nystagmus during abduction. Cranial computed tomography in our emergency department suggested cerebral infarction, and magnetic resonance imaging examination after admission confirmed the diagnosis of acute pontine cerebral infarction.
This patient was ultimately diagnosed with acute pontine cerebral infarction.
He received aspirin, clopidogrel, and butylphthalide, as well as acupuncture and Chinese herbal medicine.
After 10 days of treatment, the patient's paralysis of the eye muscles improved significantly.
Eye movement disorders are sometimes an early warning sign of impending vertebrobasilar ischemic stroke. Patients with acute ischemic stroke who have early detection of oculomotor disturbances should be promptly imaged, as missed diagnosis may lead to serious consequences or even death. It provided us with a new diagnostic idea.
眼球运动障碍通常与眼部疾病相关，很少与脑血管疾病相关。这是一例罕见的因小脑前下动脉和蜗螺旋动脉闭塞导致突发眼球运动障碍的患者。本文描述了与脑血管疾病相关的眼球运动障碍，旨在提高我们对脑血管疾病的认识，并提高早期诊断和鉴别诊断的能力。
一名 52 岁男性，在就诊前 2 天出现急性脑桥梗死。主要症状为左眼内收和外展不能，右眼外展无障碍但内收受限，外展时出现水平眼球震颤。我院急诊科行颅脑 CT 提示脑梗死，入院后行磁共振成像（MRI）检查明确急性脑桥梗死诊断。
该患者最终被诊断为急性脑桥梗死。
给予阿司匹林、氯吡格雷和丁苯酞，并进行针灸和中药治疗。
治疗 10 天后，患者眼肌瘫痪明显改善。
眼球运动障碍有时是椎基底动脉缺血性卒中即将发生的早期预警信号。对于急性缺血性卒中患者，若早期发现眼肌运动障碍，应及时进行影像学检查，否则可能导致严重后果，甚至死亡。该病例为我们提供了一个新的诊断思路。
