【摘要】 背景:与眼有关的异常联合运动是眼运动神经异常支配所致的多种复杂眼球运动异常,对其临床特点、分类普遍认识不足。目的:报告并分析眼运动神经异常支配造成的眼和眼或眼与其他非眼肌肉之间的异常联合运动临床特点,并按发生的肌肉归属神经进行分类。设计:回顾性病例分析。单位:青岛大学医学院附属医院眼科。对象:选择1997-01／2002-01到青岛大学医学院附属医院眼科就诊异常眼球运动患者836例,发现异常联合运动67例。方法:对所有患者询问病史、眼球运动检查,找出非循规眼球运动(先天性和后天性)。分析有关异常支配的神经,按发生的肌肉归属神经分动眼神经支配各肌肉间,动眼神经与外展神经之间,核上性和其他进行分类统计。主要观察指标:①询问发病时间以区分先天性和后天性。②异常联合运动发生的临床体征。结果:与眼有关的异常联合运动患者67例,占异常眼球运动患者的 8％。其中,先天性多见(88．06％),最常见于Duane综合征。在发生异常联合运动肌肉中,先天性为外直肌与内直肌和外直肌与提上睑肌间最多,各占36．89％;后天性者最多见下直肌与提上睑肌,为30％。结论:异常支配造成的眼与其他肌肉异常运动并非少见,临床上遇到非循规眼球运动时应考虑异常神经支配的存在。更多还原

【Abstract】 BACKGROUND: The clinical features and classification of various anomalous synkinetic movements related to ocular muscles caused by abnormal innervations have not been fully understood. OBJECTIVE: To report and analyze the clinical features of anomalous synkinetic movements related to ocular muscles caused by abnormal innervations, as well as to classify them according to the same neuromuscular nerves. DESIGN: A retrospective case analysis. SETTING: Department of Ophthalmology, the Affiliated Hospital of the Medical College of Qingdao University. PARTICIPANTS: The study was mainly conducted in the Department of Ophthalmology, the Affiliated Hospital of the Medical College of Qingdao University. A total of 836 cases of abnormal ocular movements were found from January 1997 to January 2002. Among them 67 cases of anomalous synkinetic movements were diagnosed. METHODS: All patients were inquired of case history and their ocular movements were examined. The anomalous synkinetic movements were found and classified into congenital and acquired. All cases were analyzed according to the same neuromuscular nerves, such as between branches of oculomotor nerve, oculomotor and abducens nerve, supranucleus and other anomalous synkinetic movements. MAIN OUTCOME MEASURES: (1) The congenital or acquired anomalous synkinetic movements were determined by inquiring the history of diseases. (2) The clinical features of anomalous synkinetic movements were observed. RESULTS: Sixty-seven anomalous synkinetic movements (8%) of 836 abnormal ocular movements were diagnosed; congenital anomalous synkinetic movements were the most common ones (88.06%) and were often seen in patients with Duane’s syndrome. Anomalous synkinetic muscles occurred the most common between lateral and medial rectus, lateral rectus and lev-ator palpebrae muscle (36.89% respectively) in congenital cases, and those occurred between inferior rectus and levator palpebrae muscle more commonly (30%) in acquired cases. CONCLUSION: Anomalous synkinetic movements related to ocular muscles are not infrequently seen. When we find paradoxical movements between ocular muscles, or between ocular muscles and other unrelated muscles, anomalous synkinetic movements should be considered.更多还原