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一位67岁男性患者出现右边颞侧头痛和右眼视力突发性无痛性丧失,出现这些症状时还伴有全部眼肌麻痹和视盘水肿。ESR和C-反应蛋白升高。核磁共振检查证实有视神经鞘膜炎的特征。右颞侧动脉的活组织切片检查正常。眼外肌运动随着全身激素的应用而好转。不幸的是此后患者右眼发展为中央视网膜动脉阻塞。全眼肌麻痹是巨细胞动脉炎的一种罕见表现,为了得到满意的治疗结果并且阻止对侧眼盲,疾病开始时使用皮质类固醇激素是必要的。
A 67-year-old male patient presents with a sudden, painless loss of right-temporal temporal and right-sided visual acuity accompanied by total ophthalmoplegia and optic disc edema. ESR and C-reactive protein increased. MRI confirmed the characteristics of optic neurovitis. Right temporal artery biopsy was normal. Extraocular muscle movement improved with the application of systemic hormones. Unfortunately, the right eye of the patient later develops into a central retinal artery occlusion. Total ophthalmoplegia is a rare manifestation of giant cell arteritis. It is necessary to use corticosteroids at the onset of the disease in order to get satisfactory treatment outcomes and to prevent contralateral blindness.