非外伤性单纯性动眼神经麻痹的临床及病因学分析OA

Objective To investigate the clinical characteristics and etiologies of non-traumatic isolated oculomotor nerve palsy and improve the diagnosis and treatment level of such disease for clinicians.Methods The clinical data of 86 patients with non-traumatic isolated oculomotor nerve palsy in the First Affiliated Hospital of Gannan Medical University were retrospectively collected from March 2019 to May 2024,and the clinical features,etiologies and prognosis were analyzed.Results Of the 86 patients with an age of onset(59.05±13.01)years,83 cases had monocular onset and 3 cases had binocular onset.Among them,there were 84 cases with varying degrees of diplopia,83 cases with ptosis,and 30 cases with pupil alteration,47 cases were accompanied with headache and 23 cases with orbital pain.The causes were attributed to diabetes in 33 cases,intracranial aneurysms in 18 cases,Tolosa-Hunt syndrome in 10 cases,intracranial tumor in 4 cases,cerebral infarction in 3 cases,carotid-cavernous fistula in 3 cases,demyelinating encephalopathy in 3 cases,other rare causes in 6 cases and unknown causes in 6 cases.Six-month of follow-up after treatment,53 cases were cured,27 cases were improved and 6 cases had no changes.Conclusion Non-traumatic isolated oculomotor nerve palsy commonly presents with monocular onset,mainly presenting with varying degrees of diplopia and ptosis,and most patients are accompanied with headache.The primary cause of which is diabetes,followed by intracranial aneurysms and Tolosa-Hunt syndrome.Most patients have a good prognosis after receiving early diagnosis and active treatment.