Inverse Duane's retraction syndrome: rare presentation of orbital myocysticercosis.

IF 0.8 Q4 OPHTHALMOLOGY
Shirali Gokahru, Elika Gupta, Sima Das
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引用次数: 0

Abstract

Introduction: Cysticercosis is a systemic parasitic disease caused by the larvae of the tapeworm Taenia and has varied clinical manifestations. Ocular involvement can be intraocular or extraocular and can mimic various etiologies and patterns of strabismus. This study reports 3 cases of orbital myocysticercosis mimicking clinical presentation of inverse Duane's retraction syndrome and discuss the clues to the clinical diagnosis. Methods: Retrospective review of medical records of three patients with medial rectus muscle cysticercosis with clinical findings mimicking acquired inverse Duane's retraction syndrome. Results: Review of medical records identified 3 patients with myocysticercosis presenting as inverse Duane's retraction syndrome with exotropia, esotropia and orthophoria in primary gaze, restricted horizontal movements and globe retraction in abduction. Ultrasound B scan or orbital computerized tomography scan confirmed the diagnosis of medial rectus muscle cysticercosis in all patients. All 3 patients were treated with oral albendazole with resolution of the cyst on follow up imaging and improvement in clinical findings. Discussion: Cysticercosis is a common parasitic infection in India and responds well to medical management. These 3 cases highlight the unusual presentation of medial rectus muscle cysticercosis presenting as acquired inverse Duane's retraction syndrome. Sudden onset strabismus and restricted extraocular movements along with signs of orbital or adnexal inflammation in a child or young adult residing in endemic areas should be evaluated to rule out myocysticercosis. Inflammation is usually painless with minimal tenderness despite marked signs of orbital or adnexal involvement. Diagnosis relies on high clinical suspicion and imaging such as ultrasound B scan, MRI, or CT, which can reveal the cyst and scolex within the muscle. Relative rarity of this presentation of myocysticercosis as inverse Duane's retraction syndrome makes it imperative for clinicians to be aware of this entity to clinch the diagnosis early and initiate prompt treatment.

杜安氏反缩回综合征:罕见的眼眶肌囊虫病。
囊虫病是一种由绦虫带绦虫幼虫引起的全身性寄生虫病,临床表现多样。眼部受累可以是眼内或眼外,可以模仿各种病因和模式的斜视。本文报告3例眼眶肌囊虫病临床表现酷似Duane's反缩综合征,并探讨其临床诊断线索。方法:回顾性分析3例临床表现酷似获得性Duane逆回综合征的内侧直肌囊虫病患者的病历。结果:回顾性分析了3例肌囊虫病患者,其临床表现为Duane's逆缩综合征,伴初视外斜视、内斜视和正斜视,水平运动受限,外展时眼球内缩。B超或眶部计算机断层扫描均可确诊为内侧直肌囊虫病。3例患者均口服阿苯达唑治疗,随访影像显示囊肿消退,临床表现改善。讨论:囊虫病在印度是一种常见的寄生虫感染,治疗效果良好。这3例突出了内侧直肌囊虫病的不同寻常的表现,表现为获得性逆Duane's回缩综合征。对于居住在流行地区的儿童或年轻人,应评估突发性斜视和眼外运动受限,并伴有眼窝或附件炎症的迹象,以排除肌囊虫病。尽管有眼眶或附件受累的明显征象,炎症通常是无痛的,有轻微的压痛。诊断依赖于高度的临床怀疑和影像,如B超扫描、MRI或CT,它们可以显示肌肉内的囊肿和头节。相对罕见的肌囊虫病表现为逆Duane's回缩综合征,这使得临床医生必须意识到这一实体,及早诊断并开始及时治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Strabismus
Strabismus OPHTHALMOLOGY-
CiteScore
1.60
自引率
11.10%
发文量
30
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