Furukawa Y, Nakajima Y, Nakagawa M, Matsumoto M, Mori H, Mizuno Y
Department of Neurology, Juntendo University School of Medicine, Tokyo.
No To Shinkei. 1994 Jun;46(6):593-600.
We report a 75-year-old woman with multiple cranial nerve palsies. The patient was well until January, 1992 when she had an onset of deafness in her left ear; she developed left facial pain in September, 1992, and came to the ENT clinic of our Izunagaoka Juntendo Hospital. She had chronic sinusitis; she was referred to neurology clinic on September 25 because of decrease in the superficial sensation in the second division of the left trigeminal nerve. She developed blurring of her left vision, and was admitted to the neurology service of Juntendo Izunagaoka Hospital on December 7th, 1992. On admission, general physical examination was unremarkable. Neurologic examination revealed alert and mentally sound woman; higher cerebral functions were intact. In the cranial nerves, olfactory sensation was normal; the left vision was reduced to discriminate light and dark; the right vision was normal. Pupils were round and isocoric, but the light reflex was sluggish on the left side; the abduction of the left eye was impossible; other ocular muscles appeared intact. Sensation of the left face was almost completely lost; the corneal reflex was lost on the left side; no jaw deviation was noted. She had near complete left facial palsy of the peripheral type; the left ear was deaf. The movement of the left soft palate was slightly weak, but no deviation of the uvula was noted; she had no dysarthria or dysphagia.2/
我们报告一名75岁患有多发性颅神经麻痹的女性。该患者此前情况良好，直到1992年1月左耳开始出现耳聋；1992年9月出现左侧面部疼痛，并前往我院伊豆长冈顺天堂医院耳鼻喉科就诊。她患有慢性鼻窦炎；9月25日因左侧三叉神经第二支浅感觉减退被转诊至神经科门诊。她出现左眼视力模糊，于1992年12月7日入住顺天堂伊豆长冈医院神经科。入院时，全身体格检查无异常。神经系统检查显示该女性意识清醒、精神状态良好；高级脑功能正常。颅神经方面，嗅觉正常；左眼视力下降至仅能分辨明暗；右眼视力正常。瞳孔圆形且等大，但左侧光反射迟钝；左眼外展受限；其他眼肌未见异常。左侧面部感觉几乎完全丧失；左侧角膜反射消失；未发现下颌偏斜。她患有几乎完全性的外周型左侧面神经麻痹；左耳失聪。左侧软腭运动稍弱，但未发现悬雍垂偏斜；她没有构音障碍或吞咽困难。
