内斜視で発見された小児の橋神経膠腫の3例

Three children of pontine glioma with esotropia as the initial manifestation

要約　目的：内斜視を主訴として眼科を受診し，脳外科または神経内科で橋神経膠腫と診断された3小児例の報告。症例：症例は4歳女児，4歳男児，10歳女児で，1例には左眼の内斜視が出現進行，第2例には転倒して頭部打撲後に内斜視が出現，第3例には頭痛と内斜視が生じた。一眼の外転制限が3例すべてにあった。3例とも脳外科または神経内科で精査が行われ，頭部CTと磁気共鳴画像検査（MRI）で橋神経膠腫が発見された。結論：小児に生じた内斜視の診断では，橋神経膠腫による外転神経麻痺を念頭に置く必要がある。画像診断ではCTよりもMRIの価値が高い。

Abstract.　Purpose：To report 3 children who presented with esotropia and who were later diagnosed as pontine glioma. Cases：The present series comprised 4-year-old girl,4-year-old boy and 10-year-old girl. One case showed progressive esotropia in the left eye. Another case manifested esotropia following blunt trauma to the head. The third case showed headache and esotropia. All the cases showed restricted abduction in one eye. All the cases were referred to specialists in neurology and were diagnosed with pontine glioma based on findings by computed tomography（CT）and magnetic resonance imaging（MRI）. Conclusion：These cases illustrate that esotropia in children may be due to abducens palsy due to compression of the nucleus by pontine glioma. MRI was more informative in the diagnosis than CT in the present cases.