Ophthalmoplegia, formerly known as ophthalmoplegia.Muscle dyskinesia, autonomous movement and reflex movement of a single muscle or the same innervated nerve are all impaired.It is characterized by infection or cerebrovascular disease before the onset, as well as diabetes, tumor, peripheral neuropathy and other incentives. Its clinical manifestations include diplopia, dilated or narrowed pupils, and eyelid or eye movement disorders.The best treatment time for ophthalmoplegia is within 3 months of the onset date. The earlier the treatment, the better.
TCM disease name
Ophthalmoplegia
Foreign name
Ophthalmoplegia
alias
Ophthalmoplegia
Visiting department
Ophthalmology Department
Common diseases
Ophthalmic muscle
Common causes
Diabetes, tumor, peripheral neuropathy, etc
common symptom
Diplopia, dilated or narrowed pupils, eyelid or eye movement disorder
Diplopia, dilated or narrowed pupils, eyelid or eye movement disorder
Etiology and common diseases
Announce
edit
Before the onset, there are infection or cerebrovascular disease, and the inducements are diabetes, tumor, peripheral neuropathy, etc.
differential diagnosis
Announce
edit
1. Peripheral ophthalmoplegia
(1) Oculomotor nerve paralysis: manifested as paralysis of the whole eye muscle, exotropia;Intraocular muscle paralysis, showing dilated pupils, disappearance of light reflex and regulatory reflex, and diplopia.
(2) Trochlear nerve paralysis: most of them are associated with oculomotor nerve paralysis, which is characterized by esotropia, inability of eyeball to rotate outwards, diplopia, inflammation, skull base tumor, aneurysm compression of oculomotor nerve, peripheral neuropathy, multiple sclerosis (MS), etc.
2. Nuclear ophthalmoplegia
Nuclear damage is manifested as partial ophthalmoplegia, mostly bilateral, with adjacent structural damage, and cross paralysis, mostly seen in cerebrovascular diseases, tumors, etc.
3. Internuclear ophthalmoplegia
There are anterior internuclear ophthalmoplegia and posterior internuclear ophthalmoplegia. The former is medial longitudinal bundle damage, which shows that the ipsilateral eyeball can be abducted, the opposite side cannot be adducted, and the abductive side can have nystagmus;The latter is the fiber damage between the visual center of the pons side and the ipsilateral abducent nucleus, which shows that the ipsilateral eyeball cannot abduct, and the contralateral eyeball can adduct.It is commonly seen in cerebrovascular diseases, brain stem tumors, etc.
4. Supranuclear ophthalmoplegia
It is manifested as the conjugate movement disorder of both eyes.Ophthalmic examination and brain CT were performed to exclude intracranial organic lesions.
5. Supranuclear vertical ophthalmoplegia
It can be seen in juvenile Niemann Pick disease (chronic neurological type C). It is mostly seen in children, and a few children or adolescents have it. Cherry red spots or supranuclear vertical ophthalmoplegia can be seen in the eyeground.
inspect
Announce
edit
1. Intraocular muscle paralysis
It is manifested as ptosis, strabismus, dilated pupils, disappearance of light reflex and accommodation reflex, etc.
2. Levator muscle paralysis
The symptoms are ptosis and strabismus of the affected eye. The line of sight of the affected eye is blocked by the drooping upper eyelid, and diplopia is generally not felt.
3. Ciliary muscle paralysis
The symptoms are that the lens regulation is obstructed, resulting in blurred near vision, dilated pupils, and disappearance of light reflex and regulatory reflex.
4. Paralysis of extraocular muscles
Most of them were paralysis of one or two extraocular muscles;The manifestations of paralysis are varied.Such as strabismus, diplopia, visual confusion and so on due to the limitation of the inward, outward, downward and upward movements of the eyeball.
5. Trochlear nerve paralysis
Multiple cases were associated with oculomotor nerve paralysis, and only trochlear nerve paralysis was rare. The symptoms were limited outward and downward movement of the eyeball, diplopia, and strabismus when looking downward and outward.
6. Abducent nerve paralysis
Strabismus and diplopia occur when looking inward and outward.
Therapeutic principles
Announce
edit
The best treatment time for ophthalmoplegia is calculated from the onset date. The best treatment period is within 3 months, and the earlier the better.Early treatment is conducive to the recovery of health as soon as possible, reducing the suffering of disease.
