Batocchi A P, Evoli A, Majolini L, Lo Monaco M, Padua L, Ricci E, Dickman A, Tonali P
Institute of Neurology, Catholic University, Rome, Italy.
J Neurol. 1997 Oct;244(10):639-45. doi: 10.1007/s004150050160.
We studied prospectively 105 unselected patients complaining of ptosis and/or diplopia due to extrinsic ophthalmic muscle palsies without other neurological signs. All patients underwent the same diagnostic protocol. The presenting symptoms were: ptosis, 35 patients (33%); diplopia, 27 patients (26%); ptosis and diplopia, 43 patients (41%). The oculomotor nerve was most frequently involved, followed by the abducens nerve. The final diagnoses were: ocular myasthenia, intracranial and/or orbital pathology, thyroid ophthalmopathy, diabetic ophthalmoplegia, mitochondrial myopathy, oculopharyngeal muscular dystrophy. In 26 patients (25%) the cause remained undetermined. Our study confirms the difficulty of establishing an aetiological diagnosis in patients with isolated ocular palsies.
我们对105例因眼外肌麻痹而出现上睑下垂和/或复视且无其他神经体征的未经挑选的患者进行了前瞻性研究。所有患者均接受相同的诊断方案。主要症状为：上睑下垂35例（33%）；复视27例（26%）；上睑下垂和复视43例（41%）。动眼神经受累最为常见，其次是外展神经。最终诊断为：眼肌型重症肌无力、颅内和/或眶内病变、甲状腺眼病、糖尿病性眼肌麻痹、线粒体肌病、眼咽型肌营养不良。26例患者（25%）病因仍未明确。我们的研究证实了在孤立性眼肌麻痹患者中确立病因诊断的困难。
