小児の動眼神経麻痺の1例

Oculomotor nerve palsy in a child

　12歳女児の左側部分動眼神経麻痺を経験した。1週前から続く複視と羞明とを主訴とし，左眼の内下転障害，瞳孔散大，調節障害および軽度眼瞼下垂を認めた。下斜筋機能は保たれていた。一部のウイルスで抗体価の上昇を認めたが，血液検査やCT, MRIなどの画像検査で原因は特定できなかった。ビタミンB₁₂製剤の内服のみで，眼瞼下垂と調節障害は発症3か月後，眼球運動は4か月後，瞳孔不同は9か月後にほぼ正常化した。

A 12-year-old girl presented with diplopia and photophobia since one week before. Her left eye showed blepharoptosis, mydriasis, impaired accommodation, and restricted movement during adduction, elevation and depres-sion. She was diagnosed with oculomotor nerve palsy. While she showed elevated titers for some virus antibodies, other laboratory examinations and diagnostic imaging failed to identify the etiology. Following treatement with peroral cyanocobalamin, blepharoptosis and accommodation recovered 3 months later, ocular movement normalized 4 months later, and anisocoria disappeared 9 months later.