摘要
目的总结5例特发性眶肌炎的临床及影像学特点。方法2008年10月至2009年9月就诊于北京大学第一医院神经内科的5例特发性眶肌炎患者，4例女性，1例男性，发病年龄27～57岁，病程3个月至4年。总结其临床特点，并对所有患者进行眼眶磁共振成像或CT检查，诊断后给予糖皮质激素治疗。结果5例患者临床均表现为持续非对称性眼睑下垂、眼外肌不完全性瘫痪以及轻微眼痛和眼球突出，3例出现缓解复发病程。所有患者的四肢肌电图检查均无重频刺激递减现象；四肢肌肉活体组织检查也没有发现肌纤维异常；肌酸激酶和甲状腺功能无异常。影像学检查发现所有患者均存在个别眼外肌的增粗或强化，其中1条眼外肌受累2例，2条眼外肌受累2例，多条眼外肌受累1例；均无眶周骨质破坏及海绵窦受累表现。全部患者经糖皮质激素治疗后症状消失或好转。结论持续性非对称性眼外肌瘫痪是眶肌炎的常见临床表现，影像学检查多表现为部分眼外肌肿胀。
Objective To report the clinical and magnetic resonance imaging （MRI） features of 5 cases with idiopathic orbital myositis. Methods Four females and one male, aged 27 to 57 years, presented department of neurology in the First Hospital of Peking University in October 2008 to September 2009. The duration of disease was between 3 months and 4 years. Recurrent course appeared in 3 of them. Orbital MRI was performed in all of them. After diagnosis they underwent long-term corticosteroid treatment. Results All patients presented ocular pain, asymmetrical and incomplete ophthalmoplegia and mild proptosis. EMG revealed no significant decline in repetitive stimulation. Muscle biopsies of limb muscle were unremarkable. Creatine kinase and thyroid function test were in normal limits. MRI revealed unilateral, focal or diffuse enlargement and enhancement of extraocular muscles, involving 1 extraocular muscle in 2 cases, 2 extraocular muscles in 2 cases, more extraocular muscles in 1 case. No evidence indicated bone destruction or cavernous sinus abnormalities. Five cases showed improvement and remission after long-term administration of steroids. Conclusion Persistent and asymmetrical ophthalmoplegia is common in orbital myositis. Extraocular muscle swelling characterized the MRI changes.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2011年第5期331-334,共4页
Chinese Journal of Neurology
关键词
肉芽肿
浆细胞
眶
展神经疾病
磁共振成像
Granuloma, plasma cell, orbital
Abducens nerve diseases
Magnetic resonance imaging
