Symptomatology And Etiology Analysis Of Oculomotor Nerve Palsy And Its Predictive Ability In Aneurysms Diagnosis

Objective We analysis cases of oculomotor nerve palsy,and compare the differences of clinical features between intracranial aneurysm induced oculomotor nerve palsy and non-intracranial aneurysm-related oculomotor nerve palsy.Methods: Cases were collected by electrical medical history system-Haitai 1.0 and 2.0.All searchable new diagnosed oculomotor nerve palsy cases were included.We recorded the clinical appearance,CTA,MRA and DSA results.Etiology,treatment and prognosis of ONP as well as some background medical states just like hypertension,DM et al.were also recorded.Patients are grouped as intracranial aneurysm induced ONP and non-intracranial aneurysm-related ONP groups.SPSS 22 were used in data analysis.Chi square test was used in analysing if the clinical features was significant correlated with etiology of ONP.Static significant is defined as P<0.05.ROC curve was used to analyse the power of clinical features at aneurysm predicting.RESULTS Present study has totally included 102 patients who were diagnosed with oculomotor nerve palsy.These patients were hospitalized in Shanghai General Hospital from January 2010 to February 2018.There were 15 patients who were intracranial aneurysm-induced oculomotor nerve palsy.Other causes covered 87 patients.Among them,18 were complete oculomotor nerve palsy and 84 were incomplete oculomotor nerve palsy.34 cases involved pupils,68 cases didn’t involved pupils.Chi-square test and receiver operating characteristic(ROC)demonstrated that completed oculomotor nerve palsy or in-completed oculomotor nerve palsy accompany with pupil involvement were related with intracranial aneurysms.The area under the curve(AUC)of the ROC curve analysis of the diagnosis of aneurysm with pupillary involvement,headache,combined with pupillary involvement and headache,combined with complete oculomotor nerve palsy and headache were similar(all greater than 0.74),indicating that the above has a strong ability to predict aneurysms,with diagnostic significance(P <0.01).Conclusion Headache,complete oculomotor palsy or oculomotor paralysis involving the pupil was associated with intracranial aneurysms.And the involvement of the pupil may be more predictive than the other factors of the presence of an aneurysm.Computed tomography angiography(CTA)should be taken as soon as possible to these patients,and further aneurysm endovascular embolization or craniotomy aneurysm clipping should be performed as soon as possible.