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目的探讨痛性眼肌麻痹的临床、影像学表现及治疗,以进一步提高对该病的诊治水平。方法回顾总结15例住院痛性眼肌麻痹患者的临床特点,并结合文献进行分析。结果15例患者多为急性或亚急性起病,绝大部分有头痛和眼肌麻痹,累及动眼神经、滑车神经和外展神经,个别患者视神经、面神经也受累;经头颅CT或MRI排除其他疾患,3例出现海绵窦病变;全部患者采用激素治疗有效。结论加强对海绵窦、眼眶和蝶鞍等部位的动态MRI检查很重要;及时就诊,把握最佳治疗窗;在使用激素治疗时应注意需要合适的剂量和维持时间。
Objective To investigate the clinical manifestations and treatment of painful ophthalmoplegia in order to further improve the diagnosis and treatment of the disease. Methods The clinical features of 15 patients with painful ophthalmoplegia were retrospectively reviewed and analyzed. Results Most of the 15 patients were acute or subacute. Most of them had headache and ophthalmoplegia, involving the oculomotor nerve, the trochlear nerve and the abducens nerve. The optic nerve and facial nerve were also involved in some patients. The others were excluded by skull CT or MRI Disease, 3 cases of cavernous sinus lesions; all patients with hormone therapy. Conclusions It is very important to strengthen the dynamic MRI examination of the cavernous sinus, orbit and sella and so on. To get the best treatment window timely, to take proper dose and maintenance time when using hormonal therapy.