Analysis of 80 cases of extraocular muscles paralysis with diplopia

Objective To evaluate clinical features of extraocular muscles paralysis that initially presented with diplopia.Methods Eighty cases with extraocular muscles paralysis were analyzed for causes of disease by reviewing medical history,a thorough physical examination and a complete eye examination.The clinical features were studied.Results Twenty-four patients with extraocular muscles paralysis were caused by diabetes,including oculomotor nerve paralysis(16 cases),abducent nerve paralysis(6 cases),and combination of oculomotor nerve and abducent nerve paralysis(2 cases).Twenty cases were caused by cerebrovascular diseases,and 18 cases were caused by arteriosclerosis resulted oculomotor and abducent nerve paralysis.Ten cases were caused by intracranial aneurysms,two cases by myasthenia gravis,one case by somatization disorder,two by intracranial tumors,one by multiple sclerosis,one by neurosyphilis,and 1 by brainstem encephalitis.Conclusions Many neurological diseases can cause nerve ophthalmic signs such as diplopia.The most common causes including diabetic ophthalmoplegia,cerebrovascular disease,and aneurysms ophthalmoplegia.Atherosclerosis is also an important cause.Other etiologies include myasthenia gravis(ocular),somatoform disorders,intracranial mass,etc.The etiology of patients with extraocular muscles paralysis and diplopia is complex and easy to be misjudged.Therefore,much attention should be paid to the exact diagnosis and proper management.