Diplopia Diagnostics: Exploring Underlying Causes and Clinical Features in Neurological Practice

Ozlem Kesim Sahin, Gursan Gunes Uygun, Devran Süer
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Abstract

Diplopia is a common complaint with two subtypes: monocular and binocular in the emergency department (ED) and outpatient clinic. Monocular diplopia is typically associated with ocular abnormalities and refractive errors, whereas binocular diplopia may indicate the presence of an underlying life-threatening cause. To emphasize the importance of identifying underlying neurologic disease in individuals experiencing diplopia. Over a 3-year period, patients admitted to the ED and neurology outpatient clinic with diplopia were retrospectively analyzed. ‘Secondary diplopia’ was defined when an organic cause was found. ‘Isolated diplopia’ was identified as the absence of additional signs and symptoms other than diplopia. All patients were examined for risk factors and investigated for an etiology. Out of the 222 (male: 138) patients, 213 (96%) had binocular diplopia. Secondary diplopia was observed in 113 (53%) patients and 82 (38.4%) had isolated diplopia. One hundred twenty-five (58.6%) patients had at least one sign or symptom associated with diplopia. The incidence of diabetes was significantly higher in secondary diplopia. Ninety-three (43.6%) patients had ocular cranial nerve palsy, most commonly in the 6th cranial nerve. Diplopia with at least one associated sign or symptom and ocular cranial nerve involvement was statistically significant for secondary diplopia. In cases of acute diplopia the presence of at least one additional associated sign or symptom was significantly higher. It is very important to investigate an underlying neurologic etiology that may be life-threatening because secondary diplopia was detected in half of the patients with diplopia in the present study.

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复视诊断:探索神经学实践中的根本原因和临床特征
复视是急诊科(ED)和门诊中常见的主诉,有两种亚型:单眼复视和双眼复视。单眼复视通常与眼部异常和屈光不正有关,而双眼复视则可能表明存在潜在的危及生命的原因。为了强调识别复视患者潜在神经系统疾病的重要性。我们对三年内急诊室和神经科门诊收治的复视患者进行了回顾性分析。当发现有器质性病因时,定义为 "继发性复视"。孤立性复视 "是指除复视外没有其他体征和症状。对所有患者进行了风险因素检查和病因调查。在 222 名患者(男性:138 人)中,213 人(96%)患有双眼复视。113名(53%)患者出现继发性复视,82名(38.4%)患者出现孤立性复视。125名(58.6%)患者至少有一种与复视相关的体征或症状。继发性复视中糖尿病的发病率明显较高。93名(43.6%)患者有眼颅神经麻痹,最常见的是第6颅神经麻痹。至少伴有一种体征或症状的复视和眼颅神经受累对继发性复视有显著的统计学意义。在急性复视病例中,出现至少一种额外的相关体征或症状的比例明显更高。在本研究中,有一半复视患者被发现患有继发性复视,因此调查可能危及生命的潜在神经系统病因非常重要。
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