Crino P B, Galetta S L, Sater R A, Raps E C, Witte A, Roby D, Rosenquist A C
Department of Neurology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
J Neuroophthalmol. 1996 Mar;16(1):44-8.
We report three patients who exhibited ophthalmoparesis as an early manifestation of progressive paraneoplastic brainstem encephalitis. In two patients, anti-Hu antibodies were detected, whereas in a third, found at postmortem to have thyroid cancer, no antibodies were identified. Postmortem examination of two patients disclosed extensive gliosis, perivascular inflammation, and cell loss in the midbrain and pontine tegmentum. In one of these patients, there was selective neuronal loss within the third, fourth, and sixth nerve nuclei. We conclude that supranuclear or nuclear ophthalmoparesis may be the initial manifestation of paraneoplastic brainstem encephalitis. Our pathologic data suggest that the ophthalmoparesis may result from selective neuronal death within the brainstem tegmentum and ocular motor nuclei.
我们报告了三名患者，他们表现出眼球运动麻痹，这是进行性副肿瘤性脑干脑炎的早期表现。其中两名患者检测到抗Hu抗体，而第三名患者在尸检时发现患有甲状腺癌，但未发现抗体。对两名患者的尸检显示，中脑和脑桥被盖广泛胶质增生、血管周围炎症和细胞丢失。在其中一名患者中，第三、第四和第六神经核内有选择性神经元丢失。我们得出结论，核上性或核性眼球运动麻痹可能是副肿瘤性脑干脑炎的初始表现。我们的病理数据表明，眼球运动麻痹可能是由于脑干被盖和动眼神经核内的选择性神经元死亡所致。
