Lesser R L, Simon R M, Leon H, Siegel N
Am J Ophthalmol. 1979 May;87(5):682-7. doi: 10.1016/0002-9394(79)90304-0.
A 17-year old girl received prednisone and azathioprine for the treatment of systemic lupus erythematosus. She developed a fever and hallucinations 18 months later; cryptococcal meningitis was diagnosed. An internal ophthalmoplegia with loss of accommodation and dilation of the pupils developed together with bilateral lateral rectus palsy. Treatment with intravenous amphotericin resulted in disappearance of papilledema, muscle palsy, and internal ophthalmoplegia. We believe that the internal ophthalmoplegia was secondary to involvement of the accommodative and pupillary fibers of both third nerves at the base of the brain.
一名17岁女孩接受泼尼松和硫唑嘌呤治疗系统性红斑狼疮。18个月后她出现发热和幻觉；被诊断为隐球菌性脑膜炎。同时出现了伴有调节功能丧失和瞳孔散大的内眼肌麻痹以及双侧外直肌麻痹。静脉注射两性霉素治疗后，视乳头水肿、肌肉麻痹和内眼肌麻痹消失。我们认为内眼肌麻痹是继发于脑底部双侧动眼神经的调节和瞳孔纤维受累。
