Analysis the clinical characteristic and etiology of external ophthalmoplegia 257 cases

Objective To discussion the clinical characteristics and etiology of external ophthalmoplegia. Methods Collected and retrospectively analyzed the etiology and clinical characteristic of 257 external ophthalmoplegia patients. Records of the patient history, clinical manifestations and corresponding neurological department of internal medicine, Ophthalmology, Endocrinology and Radiographic examination. Results Simple ptosis in 80 cases, 131 cases of simple binocular diplopia, ptosis and diplopia in 39 cases, 7 cases of eyeball fixation. 223 cases of unilateral paralysis of extraocular muscle, 32 cases of bilateral extraocular muscle paralysis. The levator paralysis in 119 cases, unilateral put on 98 cases of eyelid muscle paralysis, bilateral put on 21 cases of eyelid muscle paralysis. 84 cases of lateral rectus muscle palsy, 56 cases of unilateral lateral rectus muscle palsy, 6 cases of bilateral lateral rectus paralysis.178 cases of extraocular ophthalmoplegia of oculomotor control, 40 cases with complete paralysis, 117 cases with incomplete paralysis, combined with other extraocular ophthalmoplegia in 21 cases. Superior oblique palsy in 24 cases, alone of superior oblique palsy in 17 cases, combined with other extraocular ophthalmoplegia in 7 cases. 82 cases with orbital local pain, 12 cases with mydriasis. In 163 cases of ocular motor neuropathy patients, single oculomotor nerve palsy in 148 cases, accounting for 90.8%, 15 cases of multiple oculomotor nerve paralysis, 9.2%. Eye movement nerve injury in 110 cases, accounting for 67.5%, 16 cases, nuclear damage was 9.8%, between nuclear damage in 13 cases, accounting for 8%, nuclear damage 24 cases accounted for 14.7%.There are 14 kinds of external ophthalmoplegia etiology in this group. including myasthenia gravis, diabetic oculomotor nerve injury, atherosclerosis and ischemic ocular motor nerve injury, local nonspecific inflammatory, traumatic, local space-occupying lesions, thyroid disease, Increased intracranial pressure, intracranial posterior communicating artery aneurysm, Mitochondrial myopathy, carotid cavernous fistula, distant parts of the tumor, multiple sclerosis, local injection of botulinum toxin, progressive muscular dystrophy. In 86 cases with hypertension, 72 cases with diabetes, 22 cases of diabetes is found for the first time, 15 cases had paralysis of external ophthalmoplegia. Conclusions The main symptoms of ocular muscle paralysis is binocular diplopia and ptosis, The incidence of unilateral external ophthalmoplegia was higher than bilateral extraocular muscle paralysis, Oculomotor nerve innervation of extraocular ophthalmoplegia was the highest, followed by lateral rectus paralysis, paralysis of the superior oblique lower. Orbital pain and pupil change is paralysis of extraocular muscle common accompanied symptoms. Oculomotor nerve paralysis was the highest. Oculomotor nerve palsy with peripheral lesion was the highest. Patients with oculomotor nerve ophthalmoplegia in patients with a higher proportion of hypertension and Diabetes,. Extraocular muscle paralysis patients need regular inspections of fasting and postprandial 2 hour blood glucose, Underwent thyroid function, orbital CT, head CT and /or MRI examination, neostigmine test for external ophthalmoplegia patients in routine. For the extraocular ophthalmoplegia patients with dilated pupil, suggest underwent the DSA to exclusion the intracranial aneurysm.