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背景:与眼有关的异常联合运动是眼运动神经异常支配所致的多种复杂眼球运动异常,对其临床特点、分类普遍认识不足。目的:报告并分析眼运动神经异常支配造成的眼和眼或眼与其他非眼肌肉之间的异常联合运动临床特点,并按发生的肌肉归属神经进行分类。设计:回顾性病例分析。单位:青岛大学医学院附属医院眼科。对象:选择1997-01/2002-01到青岛大学医学院附属医院眼科就诊异常眼球运动患者836例,发现异常联合运动67例。方法:对所有患者询问病史、眼球运动检查,找出非循规眼球运动(先天性和后天性)。分析有关异常支配的神经,按发生的肌肉归属神经分动眼神经支配各肌肉间,动眼神经与外展神经之间,核上性和其他进行分类统计。主要观察指标:①询问发病时间以区分先天性和后天性。②异常联合运动发生的临床体征。结果:与眼有关的异常联合运动患者67例,占异常眼球运动患者的 8%。其中,先天性多见(88.06%),最常见于Duane综合征。在发生异常联合运动肌肉中,先天性为外直肌与内直肌和外直肌与提上睑肌间最多,各占36.89%;后天性者最多见下直肌与提上睑肌,为30%。结论:异常支配造成的眼与其他肌肉异常运动并非少见,临床上遇到非循规眼球运动时应考虑异常神经支配的存在。
BACKGROUND: Unusual conjoint movement related to the eye is a variety of complicated eye movements caused by the abnormal control of oculomotor nerves. Generally, its clinical features and classification are not well understood. OBJECTIVE: To report and analyze the clinical features of abnormal joint movement between eye and eye or eye and other non-ocular muscles caused by the abnormal control of ocular motor nerve and classify them according to the muscle attribution nerve. Design: retrospective case analysis. Unit: Affiliated Hospital of Qingdao University Medical College. PARTICIPANTS: A total of 836 patients with abnormal eye movements from the Department of Ophthalmology, Affiliated Hospital of Medical College of Qingdao University from January 1997 to January 2002 were selected and 67 cases were found to have abnormal combined exercise. Methods: All patients were asked about their medical history and eye movements to identify non-compliant eye movements (congenital and acquired). Analysis of the abnormal control of the nerves, according to the occurrence of muscular attribution neural differentiation within the innervation of the eye muscles, oculomotor nerve and abducens, nuclear and other classification statistics. MAIN OUTCOME MEASURES: ① Inquire the onset time to distinguish between acquired and acquired. ② abnormal joint movement of the clinical signs. RESULTS: Sixty-seven patients with abnormal eye movement associated with ocular anomalies accounted for 8% of patients with abnormal eye movements. Among them, congenital more common (88.06%), the most common in Duane syndrome. Abnormal joint movement in the muscle, congenital external rectus and rectus and lateral rectus and levator muscle between up to 36.89%; the most common posterior lower rectus and levator muscle , 30%. Conclusion: Abnormal eye and other muscle abnormalities caused by abnormal domination are not uncommon. Clinically, we should consider the existence of abnormal innervation in non-conforming eye movement.