目的:外展神经麻痹的病因在研究中显示出很大的差异性。这项研究旨在通过从转诊的大学医院的所有科室招募患者来确定孤立的外展神经麻痹的临床特征和潜在病因。
方法:我们回顾了在首尔国立大学Bundang医院所有科室确诊为孤立外展神经麻痹的807例患者的医疗记录,城南,大韩民国,从2003年到2020年。我们还比较了病因与先前研究中合并的患者的比例。
结果:最常见的病因是微血管(n=296,36.7%),其次是特发性(n=143,17.7%),肿瘤(n=115,14.3%),血管异常(n=82,10.2%),炎症(n=76,9.4%),和创伤性(n=35,4.3%)。患者大多由眼科医生管理(n=576,71.4%),其次是神经科医生(n=479,59.4%),急诊医师(n=278,34.4%),神经外科医生(n=191,23.7%),和其他(n=72,8.9%)。根据患者的年龄和性别以及管理中涉及的专业,病因的比例显着不同(p<0.001)。与以前报告的汇总数据相比,目前的研究表明,微血管原因的患病率较高,但创伤性和肿瘤性原因的发生率较低。
结论:先前关于孤立的外展神经麻痹的病因学分布的研究结果应考虑招募患者的人口统计学特征和所涉及的特殊性来解释。
The etiologies of abducens nerve palsy have shown a large variability among studies. This study aimed to establish the clinical features and underlying etiologies of isolated abducens nerve palsy by recruiting patients from all departments in a referral-based university hospital.
We reviewed the medical records of 807 patients with a confirmed diagnosis of isolated abducens nerve palsy at all departments of Seoul National University Bundang Hospital, Seongnam, Republic of Korea, from 2003 to 2020. We also compared the proportion of etiology with that of the patients pooled from the previous studies.
The most common etiology was microvascular (n = 296, 36.7%), followed by idiopathic (n = 143, 17.7%), neoplastic (n = 115, 14.3%), vascular anomalies (n = 82, 10.2%), inflammatory (n = 76, 9.4%), and traumatic (n = 35, 4.3%). Patients were mostly managed by ophthalmologists (n = 576, 71.4%), followed by
neurologists (n = 479, 59.4%), emergency physicians (n = 278, 34.4%), neurosurgeons (n = 191, 23.7%), and others (n = 72, 8.9%). The proportion of etiology significantly differed according to the age and sex of the patients and the specialties involved in the management (p < 0.001). Compared to the pooled data from the previous reports, the current study showed a higher prevalence of microvascular cause but a lower occurrence of traumatic and neoplastic causes.
The results of previous studies on etiologic distribution of isolated abducens nerve palsy should be interpreted with consideration of the demographic features of patients recruited and the specialties involved.