Yu Ling, Qin Wei, Hu Wenli, Yang Lei
Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2025 Jul 17;16:1592993. doi: 10.3389/fneur.2025.1592993. eCollection 2025.
Investigating the clinical features and etiological diagnosis of early isolated ocular motor nerve palsy to deepen understanding of the condition.
We retrospectively enrolled 68 patients with isolated ocular motor nerve palsy admitted our hospital between 2017 and 2024. A retrospective analysis was conducted to assess their clinical and imaging characteristics. Based on current diagnostic criteria, patients were categorized into one of the following groups: diabetic ophthalmoplegia (DO), microvascular ocular motor nerve palsies (MVP), or Tolosa-Hunt syndrome (THS). Patients were divided into two groups based on the presence of diabetes, and the clinical and imaging differences between the two groups were compared.
Of the 68 patients, 40 were male, with an average age of 61 years. There were 43 patients with diabetes, and 40 had a history of hypertension. The number of patients with isolated 3rd, 4th, and 6th nerve palsy was 42, 15, and 11, respectively. Sixty patients experienced headache or orbital pain. 46 patients met the criteria for MVP. Among them, 31 patients had DO, and 15 non-diabetic patients also met the criteria for MVP. Of the 46 patients, 22 showed abnormalities on contrast-enhanced MRI. 19 patients were diagnosed with THS. In the diabetic and non-diabetic groups, 11 and 9 patients, respectively, were diagnosed with THS. The number of patients receiving steroid treatment in the diabetic and non-diabetic groups was 38 and 23, respectively, with pain relief rates within 3 days of 70 and 56%, > 0.05.
Currently, the boundaries between DO, MVP, diabetes combined with THS, and benign THS remain unclear. There is a need for clinical research involving specialists in neurology, ophthalmology, and otolaryngology to establish standardized definitions, classifications, and diagnostic criteria.
探讨早期孤立性动眼神经麻痹的临床特征及病因诊断，以加深对该疾病的认识。
我们回顾性纳入了2017年至2024年间我院收治的68例孤立性动眼神经麻痹患者。进行回顾性分析以评估其临床和影像学特征。根据现行诊断标准，将患者分为以下组之一：糖尿病性眼肌麻痹（DO）、微血管性动眼神经麻痹（MVP）或托洛萨-亨特综合征（THS）。根据是否患有糖尿病将患者分为两组，比较两组的临床和影像学差异。
68例患者中，男性40例，平均年龄61岁。有43例糖尿病患者，40例有高血压病史。孤立性第3、4和6脑神经麻痹的患者数分别为42例、15例和11例。60例患者出现头痛或眼眶疼痛。46例患者符合MVP标准。其中，31例患者患有DO，15例非糖尿病患者也符合MVP标准。46例患者中，22例在增强MRI上显示异常。19例患者被诊断为THS。在糖尿病组和非糖尿病组中，分别有11例和9例患者被诊断为THS。糖尿病组和非糖尿病组接受类固醇治疗的患者数分别为38例和23例，3天内疼痛缓解率分别为70%和56%，P>0.05。
目前，DO、MVP、糖尿病合并THS和良性THS之间的界限仍不明确。需要神经病学、眼科和耳鼻喉科专家开展临床研究，以建立标准化的定义、分类和诊断标准。
