Clinical Significance of MRI Contrast Enhancement of the Oculomotor Nerve in Ischemic Isolated Oculomotor Nerve Palsy.
inflammation
ischemia
neuroimaging
oculomotor nerve palsy
Journal
Journal of clinical neurology (Seoul, Korea)
ISSN: 1738-6586
Titre abrégé: J Clin Neurol
Pays: Korea (South)
ID NLM: 101252374
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
02
04
2020
revised:
10
07
2020
accepted:
10
07
2020
entrez:
8
10
2020
pubmed:
9
10
2020
medline:
9
10
2020
Statut:
ppublish
Résumé
Contrast enhancement of the oculomotor nerve in MRI was recently noticed in patients with clinical ischemic isolated oculomotor nerve palsy (iIONP). The opinions about whether this is a sign of inflammation and whether or not to administer steroids vary between doctors. The study aimed to determine the associations between this enhancement and vascular-disease risk factors (VRFs) and inflammatory factors in iIONP patients. The study recruited patients who had experienced iIONP during the previous 2 years. They were divided into groups A and B based on whether or not they exhibited an enhanced oculomotor nerve in MRI of the cavernous sinus using thin-section, fat-suppressed, and contrast-enhanced sequences. VRFs, inflammatory factors, and improvement scores were compared between the two groups. Most (71.1%) of the 45 included iIONP patients had enhanced oculomotor nerves in MRI. VRFs, periorbital pain, elevated C-reactive protein and erythrocyte sedimentation rate, the neutrophil-to-lymphocyte ratio, and the platelet-to-lymphocyte ratio were not significantly associated with the enhancement. Four of the five patients in group A exhibited an elevated cerebrospinal fluid (CSF) IgG synthesis rate. The improvement score of eight patients who received 80 mg of methylprednisolone in addition to the routine therapy was not significantly different from the scores of the other patients ( More than half of the iIONP patients had an enhanced oculomotor nerve in MRI. A few of them also had elevated CSF IgG synthesis rate, but no further evidence for inflammation was found. The administration of steroids seemed to have no benefit other than increasing the blood glucose level.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Contrast enhancement of the oculomotor nerve in MRI was recently noticed in patients with clinical ischemic isolated oculomotor nerve palsy (iIONP). The opinions about whether this is a sign of inflammation and whether or not to administer steroids vary between doctors. The study aimed to determine the associations between this enhancement and vascular-disease risk factors (VRFs) and inflammatory factors in iIONP patients.
METHODS
METHODS
The study recruited patients who had experienced iIONP during the previous 2 years. They were divided into groups A and B based on whether or not they exhibited an enhanced oculomotor nerve in MRI of the cavernous sinus using thin-section, fat-suppressed, and contrast-enhanced sequences. VRFs, inflammatory factors, and improvement scores were compared between the two groups.
RESULTS
RESULTS
Most (71.1%) of the 45 included iIONP patients had enhanced oculomotor nerves in MRI. VRFs, periorbital pain, elevated C-reactive protein and erythrocyte sedimentation rate, the neutrophil-to-lymphocyte ratio, and the platelet-to-lymphocyte ratio were not significantly associated with the enhancement. Four of the five patients in group A exhibited an elevated cerebrospinal fluid (CSF) IgG synthesis rate. The improvement score of eight patients who received 80 mg of methylprednisolone in addition to the routine therapy was not significantly different from the scores of the other patients (
CONCLUSIONS
CONCLUSIONS
More than half of the iIONP patients had an enhanced oculomotor nerve in MRI. A few of them also had elevated CSF IgG synthesis rate, but no further evidence for inflammation was found. The administration of steroids seemed to have no benefit other than increasing the blood glucose level.
Identifiants
pubmed: 33029972
pii: 16.653
doi: 10.3988/jcn.2020.16.4.653
pmc: PMC7541971
doi:
Types de publication
Journal Article
Langues
eng
Pagination
653-658Subventions
Organisme : Capital Medical University
ID : TRYY-KYJJ-2017-054
Pays : China
Informations de copyright
Copyright © 2020 Korean Neurological Association.
Déclaration de conflit d'intérêts
The authors have no potential conflicts of interest to disclose.
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