椎基底動脈延長擴大造成單側外旋神經輕度麻痺－病例報告

外旋神經麻痺是最常見的眼外肌麻痺，在50歲以上者，最常導因於血管疾患或其他不明病因。一53歲男性，苦於水平性複視已經1年。固然兩側眼球運動很難看出有任何顯著的異常，但複視測驗顯示患者在向左注視時，會出現水平非交叉性的複影。由於左眼所見之影像會位於外側，應為左眼外直肌輕度麻痺所致。合併血管造影之電腦斷層及磁振造影顯示椎基底動脈延長擴大。本個案之病因較有可能是延長擴大的基底動脈向左扭曲，直接對左側外旋神經造成牽扯及壓迫，導致左側外旋神經輕度麻痺，建議保守治療。

關鍵字

複視；外旋神經輕度麻痺；延長擴大；椎基底動脈

並列摘要

Abducens palsy is the commonest extraocular muscle palsy. Vascular disease or an unknown cause are the most common reasons for this disease in adults older than 50 years. A 53-year-old man presented who had suffered from horizontal diplopia for 1 year. It was not easy to find any significant abnormality of any eyeball movement; however, the red glass test showed horizontal uncrossed diplopia that occurred during leftward gazing, but the visual imaging of the left eye was lateral to that of the right; as a result left lateral rectus muscle paresis was confirmed. Computed tomographic angiography and magnetic resonance angiography demonstrated a dolicoectatic vertebrobasilar artery. It is probable that the dolicoectatic basilar artery had twisted leftward and compressed and stretched the left abducens nerve, leading to left abducens paresis. Conservative treatment was recommended.

並列關鍵字

diplopia ； abducens nerve paresis ； dolicoectasia ； vertebrobasilar artery

參考文獻

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延伸閱讀

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椎基底動脈延長擴大造成單側外旋神經輕度麻痺－病例報告

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