病例报告

三叉神经鞘瘤并发神经麻痹性角膜炎一例

Trigeminal schwannoma complicated with nerve paralysis keratitis: a case report

:360-363
 
该文报道一例中年男性患者,因“头痛伴左侧听力下降”就诊于我院神经外科,经影像学检查诊断为“左侧三叉神经鞘瘤”, 手术前实验室检查发现血象异常,经血液科会诊后诊断为多发性骨髓瘤IgDλ型,于化疗期间并发神经麻痹性角膜炎(neurotrophic keratitis,NK),可于角膜中央偏下方的上皮及前基质层见到类圆形的灰白色浑浊,呈胶冻样,经局部药物治疗后好转,但残留角膜基质白色浑浊。由于现阶段临床对NK尚欠缺充分认识,易延误诊治,并且本文报道的此例NK患者,因其有化疗病史且于治疗期间出现相关体征,易被误诊为化疗并发细菌性角膜炎,文章通过分析其角膜病变的特征及简单回顾NK的临床特征、鉴别诊断及治疗,以期临床早期识别及治疗此类患者,恢复角膜的光学特性,维持良好的视觉体验。
Tis article reports a case of a middle-aged male patient who visited the Department of Neurosurgery of our hospital due to headache and lef hearing loss. He was diagnosed with lef trigeminal schwannoma by imaging examination and abnormal blood routine before surgery. During chemotherapy and paralytic keratitis (neurotrophic keratitis, NK), can be seen in the lower part of the corneal center of the epithelium and the prestromal layer of round gray and white turbidities, jelly like, afer local drug treatment improved, but residual corneal stromal white turbidities. Due to the lack of full understanding of NK in clinic at the present stage, diagnosis and treatment is easy to be delayed. In addition, the NK patient reported in this paper was easily misdiagnosed as bacterial keratitis complicated by chemotherapy due to his history of chemotherapy and related signs during treatment. Tis paper analyzed the characteristics of keratopathy and briefy reviewed the clinical characteristics, diferential diagnosis and treatment of NK, in order to identify and treat these patients in early clinical stage, restore the optical characteristics of cornea and maintain good visual experience.
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  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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