ABSTRACT
Objective:To identify the potential intracranial inflammation in neuromyelitis optica spectrum disorders(NMOSD) patients without supratentorial MRI lesions using quantitative susceptibility mapping (QSM).Methods:Seventy NMOSD patients and 35 age- and gender-matched healthy controls (NC) underwent QSM, 3D-T 1, diffusion MRI from Beijing Tiantan Hospital during June 2019 to June 2021. Susceptibility was compared among NMOSD patients with acute attack (ANMOSD), NMOSD patients in chronic phase (CNMOSD) and NC. The correlation between susceptibility in several brain regions and the cerebrospinal fluid levels of inflammatory makers were analyzed. Results:NMOSD patients showed different susceptibility in several brain regions including bilateral hippocampus, precuneus, right cuneus, putamen, superior parietal and inferior temporal ( P<0.001) and the posr-hoc showed it is higher than normal. Compared to CNMOSD patients, the ANMOSD patients showed increased susceptibility in the cuneus (0.009 ± 0.004 vs. 0.005 ± 0.004, P<0.05). There was significant positive correlations between susceptibility and CSF levels of sTREM2 which reflect the active of microglial cells ( r = 0.494, P<0.05). Conclusions:Despite the absence of supratentorial lesions on MRI, increased susceptibility suggests underlying inflammation in the cerebral cortex in both patients with ANMOSD and CNMOSD, and some of them are obviously related to inflammatory markers in CSF. QSM sequence can be used to explore the potential inflammation in NMOSD patients without obvious supratentorial lesions.
ABSTRACT
Oculomotor nerve plays an important role in regulating the function of eyeball by controlling levator palpebrae superioris muscle, superior rectus muscle, inferior rectus muscle, medial rectus muscle, inferior oblique muscle, sphincter pupillae muscle and ciliary muscle. Oculomotor nerve palsy is a common clinical symptom characterized by diplopia, ptosis, ophthalmoplegia or pupillary dysfunction. The etiologies of oculomotor nerve palsy are complicated, including intracranial aneurysm, cerebral infarction and hemorrhage, diabetes, intracranial inflammation, craniocerebral trauma, congenital disease and so on. Palsy caused by different etiologies has corresponding clinical features. In this review, we summarized the common causes of oculomotor nerve palsy-and their corresponding pathogenesis, clinical manifestations, signs, treatments and prognosis, hoping to provide help for rapid identification of etiology and effective treatment of the oculomotor nerve palsy.