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WEBINO:单侧中脑血管事件独特的神经眼科表现。

WEBINO: A unique neuro-ophthalmological manifestation of the unilateral mid-brain cerebrovascular event.

作者信息

Parepalli Avinash, S Toshniwal Saket, Kinkar S Jiwan, Acharya Sourya, Reddy B Nikhil

机构信息

Department of General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, India.

Department of Neurology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, India.

出版信息

Radiol Case Rep. 2024 Nov 30;20(2):1160-1164. doi: 10.1016/j.radcr.2024.10.135. eCollection 2025 Feb.

DOI:10.1016/j.radcr.2024.10.135
PMID:39687842
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11648763/
Abstract

WEBINO (wall eye intranuclear ophthalmoplegia) is a specific type of neuroophthalmological condition that occurs due to a lesion in the MLF (medial longitudinal fasciculus), which causes unique symptoms characterized by bilateral adduction (inward movement of the eyes) impairment. Still, the abduction (outward movement of the eyes) may be preserved, and nystagmus during abduction is seen along with severe exotropia (outward movement of the eyes). In this case report, we report a 65-year-old male with a sudden onset of double vision, which he noticed while watching television, associated with a certain degree of vision loss and right-sided weakness of the body. Upon investigation, his imaging revealed an ischemic lesion in the unilateral midbrain involving his MLF. Lessons learned from this case are: This case spotlights the need for recognizing the WEBINO in cases of cerebrovascular events. It points out that for early diagnosis and proper treatment of WEBINO to achieve better results, there is a low incidence of stroke as the cause, more research is required, or better prognosis and treatment strategies in patients of WEBINO. It also underlines the need of comprehensive treatment measures, such as risk factor reduction and rehabilitation, for improving recovery and preventing future cerebrovascular episodes.

摘要

WEBINO(壁式眼球同向性核间性眼肌麻痹)是一种特殊类型的神经眼科疾病,由于内侧纵束(MLF)受损而发生,其导致的独特症状表现为双侧内收(眼球向内运动)障碍。不过,外展(眼球向外运动)功能可能保留,外展时可见眼球震颤并伴有严重的外斜视(眼球向外运动)。在本病例报告中,我们报告了一名65岁男性,他在看电视时突然出现复视,伴有一定程度的视力丧失和身体右侧无力。经检查,其影像学显示单侧中脑存在缺血性病变,累及内侧纵束。从该病例中吸取的经验教训是:本病例凸显了在脑血管事件病例中识别WEBINO的必要性。它指出,对于WEBINO的早期诊断和恰当治疗以取得更好的效果,由于中风作为病因的发生率较低,需要更多的研究,或者在WEBINO患者中有更好的预后和治疗策略。它还强调了采取综合治疗措施的必要性,如降低危险因素和进行康复治疗,以促进恢复并预防未来的脑血管事件。

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本文引用的文献

1
A rare case of a wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome in a patient with cutaneous lupus erythematosus after COVID-19 infection.1例新冠病毒感染后皮肤红斑狼疮患者出现外展神经和面神经核间性眼肌麻痹(WEBINO)综合征的罕见病例。
J Neurol. 2023 Mar;270(3):1224-1228. doi: 10.1007/s00415-022-11548-3. Epub 2022 Dec 28.
2
Case report: A variant of wall-eyed bilateral internuclear ophthalmoplegia from unilateral pons infarction.病例报告:单侧脑桥梗死所致的一种变异型外展神经麻痹性双眼核间性眼肌麻痹
Front Neurosci. 2022 Sep 9;16:974645. doi: 10.3389/fnins.2022.974645. eCollection 2022.
3
Midbrain Ischemic Strokes Presenting as Isolated Internuclear Opthalmoplegia.
表现为孤立性核间性眼肌麻痹的中脑缺血性卒中
Cureus. 2021 Sep 8;13(9):e17819. doi: 10.7759/cureus.17819. eCollection 2021 Sep.
4
Stroke in India: A systematic review of the incidence, prevalence, and case fatality.印度的中风情况:一项关于发病率、患病率和病死率的系统评价。
Int J Stroke. 2022 Feb;17(2):132-140. doi: 10.1177/17474930211027834. Epub 2021 Jul 2.
5
Wall-Eyed Bilateral Internuclear Ophthalmoplegia by Ischemic Stroke: Case Report and Literature Review.壁报眼双侧核间眼肌麻痹由缺血性脑卒中引起:病例报告及文献复习。
Neurologist. 2020 May;25(3):82-84. doi: 10.1097/NRL.0000000000000271.
6
WEBINO syndrome (wall-eyed bilateral internuclear ophthalmoplegia) secondary to ischemic stroke, about a case.WEBINO 综合征(双眼眼肌麻痹性核间性眼肌麻痹)继发于缺血性脑卒中,介绍 1 例。
Arch Soc Esp Oftalmol (Engl Ed). 2020 Apr;95(4):205-208. doi: 10.1016/j.oftal.2019.12.012. Epub 2020 Feb 20.
7
Wall-eyed bilateral internuclear ophthalmoplegia: review of pathogenesis, diagnosis, prognosis and management.外展神经麻痹性双侧核间性眼肌麻痹:发病机制、诊断、预后及治疗综述
Clin Exp Optom. 2015 Jan;98(1):25-30. doi: 10.1111/cxo.12200. Epub 2014 Oct 12.
8
Stroke management.中风管理。
Ann Indian Acad Neurol. 2011 Jul;14(Suppl 1):S82-96. doi: 10.4103/0972-2327.83084.
9
Wall-eyed bilateral internuclear ophthalmoplegia from lesions at different levels in the brainstem.脑干不同水平病变所致的外展神经麻痹性双侧核间性眼肌麻痹
J Neuroophthalmol. 2007 Mar;27(1):9-15. doi: 10.1097/WNO.0b013e3180334e8d.
10
Internuclear ophthalmoplegia: causes and long-term follow-up in 65 patients.核间性眼肌麻痹:65例患者的病因及长期随访
Acta Neurol Scand. 2004 Sep;110(3):161-5. doi: 10.1111/j.1600-0404.2004.00278.x.