多发性硬化症表现为颅内VI副瘫痪伴复视

Thiago Sande Miguel, Vinicius Sande Miguel, Daniel Almeida da Costa, Maurício Bastos Pereira
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摘要

目的:描述一例以脑瘫为表现的多发性硬化症伴复视。病例表现:A.P.R.女,31岁,复视04天。她否认了太多的症状和合并症无眼部外伤及眼部手术史。讨论:多发性硬化症(MS)是一种慢性、免疫介导的中枢神经系统脱髓鞘疾病,主要影响年轻成年女性。大约85%的多发性硬化症患者以复发的形式开始临床表现,很少有进行性神经功能障碍的患者,尽管在病程中偶尔会出现复发。眼部变化在多发性硬化症中很常见,通常是第一个临床表现。结果:多发性硬化症是一种罕见的合并症,目前尚无确切、具体的流行病学研究。在拉丁美洲国家,关于眼部改变的研究也很少。眼部受累可能是多发性硬化症的第一个症状,虽然多发性硬化症是脑神经麻痹的罕见病因,但其在年轻人中的发病率增加,以外展神经麻痹为主,正如本报告中的患者所发生的那样,强调了解这种疾病的概况的重要性。结论:MS的眼部表现包括视神经炎、视网膜炎、周围血管炎、眼球运动异常,可表现为复视或眼球震颤,这些表现应引起眼科医生的重视。
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Multiple Sclerosis Manifested by Paralysis of Cranial VI Pair with Diplopia
Aims: To describe a Multiple Sclerosis Manifested by Paralysis of Cranial VI Pair with Diplopia. Presentation of Case: A.P.R. female patient, 31 years old, has presented diplopia for 04 days. She denied too many symptoms and comorbidities. No eye trauma and previous eye surgery. Discussion: Multiple Sclerosis (MS) is a chronic, immune-mediated and demyelinating disease of the central nervous system that mainly affects young female adults. About 85% of individuals with MS start the clinical picture in the form of a relapse, and less can open the picture with progressive neurological deficits, although occasional relapses occur during the course of the disease. Eye changes are frequent in MS and are often the first clinical manifestation. Results: MS is a rare comorbidity and there are no exact and concrete epidemiological studies so far. Studies about eye alterations are also scarce in Latin American countries. Ocular involvement may be the first sign of MS. Although MS is an uncommon cause of cranial nerve palsies, its frequency increases in young individuals, with a predominance of abducens nerve palsy, as occurred with the patient in the present report, emphasizing the importance of knowing the profile of this disease. Conclusion: Ocular findings in MS include optic neuritis, retinitis, peripheral vasculitis, ocular motility abnormalities that can manifest as diplopia or nystagmus, and these manifestations should be recognized by ophthalmologists.
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