弹性睑带应用治疗双侧不完全性克劳德综合征双侧重度上睑下垂1例。

Brain & NeuroRehabilitation Pub Date : 2023-10-31 eCollection Date: 2023-11-01 DOI:10.12786/bn.2023.16.e29
Cho Rom Ham, Yong Wook Kim, Jong Mi Park
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引用次数: 0

摘要

脑干中风患者可表现为各种眼部运动障碍,包括上睑下垂。神经源性上睑下垂是由第三脑神经和/或臀肌的全部或部分功能障碍引起的,可严重限制日常生活活动和参与康复。因此,手术干预是一种有效的治疗策略。然而,由于不完全眼睑闭合的并发症,如暴露性角膜炎和角膜损伤,神经源性上睑下垂患者应首先观察,因为尽管预后不佳,但可以不手术自然恢复。我们报告了一位66岁的双侧Claude综合征的女性,她在双侧中脑梗死后表现为严重的双侧上睑下垂、四肢瘫和认知障碍。经过3个月的软弹性眼睑带强化康复,患者的上睑下垂得到改善,无需眼睑带,视野明显增加,功能水平提高到无需辅助即可独立行走。本报告显示,对于急性脑卒中后严重双侧上睑下垂的患者,使用软弹性眼睑带进行简单而有效的非手术干预,可以恢复显著的功能增益。
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The Effect of Elastic Eyelid Band Application on Bilateral Severe Ptosis in a Patient With Bilateral Incomplete Claude's Syndrome: A Case Report.

Patients with brainstem stroke can present with various oculomotor disorders, including ptosis. Neurogenic ptosis, which results from total or partial dysfunction of the third cranial nerve and/or the Müller muscle, can significantly restrict activities of daily living and participation in rehabilitation. Therefore, surgical intervention is an effective therapeutic strategy. However, owing to complications associated with incomplete eyelid closure, such as exposure keratitis and corneal injury, patients with neurogenic ptosis should first be observed, as natural recovery without surgery can be expected despite a poor prognosis. We reported the case of a 66-year-old woman with bilateral Claude syndrome who presented with severe bilateral ptosis, quadriparesis, and cognitive impairment after a bilateral midbrain infarction. After 3 months of intensive rehabilitation using soft elastic eyelid bands, her ptosis improved without the need for eyelid bands and visual field significantly increased, with improved functional level to the point of walking independently without assistance. This report demonstrates the potential advantages of the simple yet effective nonsurgical intervention of a soft elastic eyelid band for ptosis to restore significant functional gains in patients with severe bilateral ptosis after acute stroke.

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