Abstract
Introduction Recurrent painful ophthalmoplegic neuropathy (RPON) is quite rare and usually occurs in children. In this report, we describe the clinical features, diagnosis, and treatment of RPON in adults. Methods A retrospective review was conducted of all RPON cases seen and treated at the Zhongshan Ophthalmic Center of Sun Yat-sen University and the Department of Neurology of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China, over the period from January 2016 to May 2020. Results A total of 8 patients (3 males and 5 females) with a mean age of 42.9 years (range: 23–64 years) met the diagnostic criteria of RPON. Headaches were present prior to the onset of ophthalmoplegic neuropathy in 50% of these patients, while in the remaining 50%, headaches occurred simultaneously with eye symptoms. The degree of these headaches was described as being mild or moderate. Abnormalities involving cranial nerve III were the most frequently reported pathologies (6 cases, 75%), followed by nerve VI (4 cases, 50%) and then nerve IV (1 case, 12.5%) (more than one nerve was affected in some cases). Following either with glucocorticoid treatment or with observation only, symptoms and signs within all 8 patients completely dissipated within 3–28 days. Conclusions All adult cases of RPON along with their clinical features as reported here were similar to those of children.
Highlights
Recurrent painful ophthalmoplegic neuropathy (RPON) is quite rare and usually occurs in children
Erefore, in this report, we conducted a retrospective review of RPON cases at our ophthalmic and neurology centers to compile a characterization of the clinical features, diagnosis, and treatment of RPON. is review was limited to RPON cases in adults as this group has been largely ignored with regard to this condition
A total of 8 patients were recruited in this study. ere were 3 males and 5 females with a mean age of 42.9 years. e left eye was affected in 4 cases, the right in 3 cases, and both eyes in 1 case. e mean time of RPON duration was 8.25 years. e main symptoms in all cases consisted of headaches, diplopia, and ocular motility restrictions. e initial frequency of RPON attacks ranged from 0.5–6 times/year
Summary
Recurrent painful ophthalmoplegic neuropathy (RPON) is quite rare and usually occurs in children. We describe the clinical features, diagnosis, and treatment of RPON in adults. All adult cases of RPON along with their clinical features as reported here were similar to those of children. Recurrent painful ophthalmoplegic neuropathy (RPON) represents a type of PO but is distinguished by repeated attacks and an absence of any known etiology, nerve enhancement or demyelinating cranial neuropathy has been suspected in some cases [4,5,6,7,8,9]. Erefore, in this report, we conducted a retrospective review of RPON cases at our ophthalmic and neurology centers to compile a characterization of the clinical features, diagnosis, and treatment of RPON. Erefore, in this report, we conducted a retrospective review of RPON cases at our ophthalmic and neurology centers to compile a characterization of the clinical features, diagnosis, and treatment of RPON. is review was limited to RPON cases in adults as this group has been largely ignored with regard to this condition.
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