Oftalmoplegia

Abbozzo
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Oftalmoplegia
Test per oftalmoplegia
Specialitàoftalmologia
Classificazione e risorse esterne (EN)
ICD-10H49.3 e H49.4
MeSHD009886
Modifica dati su Wikidata · Manuale

In medicina, per oftalmoplegia si intende una paralisi della muscolatura estrinseca o intrinseca del bulbo oculare che impedisce i movimenti del bulbo stesso, compresi quelli involontari dell'accomodazione. È dovuta a traumi, mancanza della tiamina (vitamina B1), affezioni di origine infiammatoria, botulismo, lesioni vascolari, miopatie[1] o tumori.

Cause

L'oftalmoparesi può derivare da disturbi di varie parti dell'occhio e del sistema nervoso come:

  • Infezione degli annessi oculari: l'oftalmoplegia è un risultato importante nella cellulite orbitale.[2]
  • L'orbita dell'occhio, comprese le restrizioni meccaniche del movimento oculare, come nella malattia di Graves.
  • Il muscolo, come nell'oftalmoplegia esterna progressiva o nella sindrome di Kearns-Sayre.
  • La giunzione neuromuscolare, come nella miastenia grave.
  • I nervi cranici rilevanti (in particolare quelli oculomotori, trocleari e addotti), come nella sindrome del seno cavernoso o aumento della pressione intracranica.
  • I nuclei del tronco cerebrale di questi nervi, come in alcuni schemi di ictus cerebrale come la sindrome di Foville.
  • Tratti di sostanza bianca che collegano questi nuclei, come nell'oftalmoplegia internucleare, una scoperta occasionale nella sclerosi multipla.
  • Strutture del mesencefalo dorsale, come nella sindrome di Parinaud.
  • Alcune parti della corteccia cerebrale (compresi i campi oculari frontali), come in ictus.
  • La carenza di tiamina può causare oftalmoparesi in soggetti sensibili; questo fa parte della sindrome chiamata encefalopatia di Wernicke. Il percorso causale con cui ciò accade non è noto. L'intossicazione con alcune sostanze, come la fenitoina, può anche causare oftalmoparesi.

Note

  1. ^ Jungbluth H, Wallgren-Pettersson C, Laporte J., Centronuclear (myotubular) myopathy, in Orphanet Journal of Rare Diseases., Sep 25;3:26. 2008.
  2. ^ Orbital Cellulitis Clinical Presentation: History, Physical Examination, su emedicine.medscape.com. URL consultato il 2 aprile 2020.

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