The Clinical Analysis Of Oculomotor Nerve Palsy In 52 Patients

Objective:To analyze the causes ,clinical manifestations ,methods of examination, treatments and prognoses of oculomotor nerve palsy.Methods: 52 cases with oculomotor nerve palsy were selected from China-Japan Union Hospital of Jilin University from 2005 to 2010. The causes, clinical manifestations, methods for early diagnosis and prognosis were analyzed.RESULTS: The main cause of oculomotor nerve palsy was diabetes, found in 16 cases (30.8%) in this study. The secondary cause was intracranial aneurysm ( 13 cases ,25%). The ischemic stroke of brain stem was found in 8 cases(16%), and tuberculous meningitis in 2 cases(3.8%). Other rare causes included tolosa-hunt syndrome,pontine cavernous angioma and nasopharyngeal carcinoma (1 case in each disease).There were 4 cases (8%) could not get the final diagnosis. Patients can be divided into three groups according to the recovery when discharged : cured, 2 cases (4%); improved, 29 cases (56%);ineffective,21 cases (40%).Conclusion:1. Many causes can lead to oculomotor nerve palsy, even some can lead to fatal outcome. So that diseases should be identified carefully and diagnosed early.2. When we analyze oculomotor nerve palsy, we should check whether it is a complication of diabetes. Even if a diagnosis of diabetes was definite, we still need to take full account of the possibility of other causes, such as intracranial aneurysm and cerebral vascular disease ,and so on. Because aneurysm is fatal , DSA or CTA examination is necessary.3. Diabetes is a major cause of oculomotor nerve palsy and a risk factor for cerebrovascular disease .It should be intervened actively.4. The prognoses of oculomotor nerve palsy ,which were generally unfavorable, varied by different causes. Early etiological treatments are demanded. But we still need more clinical materials in order to enhance understanding of those causes and therapy the patients more rationally.