Extraocular muscle swine cysticercosis
Introduction
Introduction to extraocular muscle cysticercosis Extraocular muscle cysticercosis refers to extraocular muscle lesions caused by recurrent inflammation and adhesion caused by cysticercosis of the eyeball rotator muscle, also known as extraocular muscle cysticercosis. Due to the recurrent inflammatory response of this disease, it is often confused with other inflammations in the sputum to cause missed diagnosis or misdiagnosis. basic knowledge The proportion of illness: 0.0035% Susceptible people: no special people Mode of infection: fecal mouth spread Complications: cerebral cysticercosis
Cause
Extraocular muscle cysticercosis
Cause:
There are two main aspects of the infection of cysticercosis in the eye:
1. Mistaken eggs are digested, and the six hooks are removed from the small intestine and invade the intestinal wall to develop into cysticercosis through blood circulation to the organs such as the eye or subcutaneous tissue;
2. Self-infected pigs with mites can reverse the pregnancy into the stomach due to nausea, digested by gastric juice, and the eggs are released to the small intestine to hatch six hooks; if the patient's hygiene habits are not good, they may not be washed, and the hands may be contaminated with insects. Eggs can also cause infection after eating.
Prevention
Extraocular muscle cysticercosis prevention
Pay attention to food hygiene.
Complication
Extraocular muscle cysticercosis complications Complications, cerebral cysticercosis
Can be combined with cysticercosis in other parts of the body, or combined with retinal vitreous cysticercosis, cerebral cysticercosis or subcutaneous cysticercosis mass.
Symptom
Extraocular muscle cysticercosis symptoms common symptoms eyeball protruding eyeball can not be free to edema eyelid edema congestion conjunctival hyperemia nodule double vision
1. Local recurrent inflammatory reaction local conjunctival hyperemia, edema, severe eyelid edema, this inflammatory reaction is mostly located in the adductor or walking part of the rectus muscle, can touch the inflammatory mass, treated with antibiotics and corticosteroids After that, the inflammation is reduced or subsided, and relapses after several days or weeks, and the number of relapses ranges from 2 to 6 times.
2. Double vision due to the stimulation of cystic endotoxin, the affected extraocular muscles are locally swollen, the function is weakened, the eyeball is restricted, and the symptoms of diplopia appear. This kind of diplopia occurs only when looking at the direction of the affected muscles, and rarely occurs. The eye position is skewed in the first eye position.
3. Eye movement limitation Due to repeated inflammation, the affected extraocular muscles adhere to the surrounding tissue to form an inflammatory mass, which limits the contractile function of the extraocular muscles, and the traction test has obvious resistance.
4. The extraocular rectus cysticercosis, which occurs in front of the equator of the eyeball, rarely causes the eyeball to protrude. However, under the slit lamp, a cystic mass of the cyst attached to the muscle attachment is visible, and the eye is located behind the equator. The external muscle cysticercosis is prone to cause eyeballs to protrude, because the cystic inflammatory reaction here can affect adjacent muscles or intraorbital tissues, causing tissue swelling or formation of large inflammatory masses, pushing the ocular protrusion.
Examine
Examination of extraocular muscle cysticercosis
The use of enzyme-linked immunosorbent assay (ELISA) to detect positive patients indicates that the patient has been infected with cysticercosis, which has certain diagnostic value.
1. B-type ultrasound examination can be seen in the area of the extraocular muscles, which can be seen in the dark area of the circular-like echogenic liquid. The internal echo is uneven and the edges are smooth. Sometimes the head of the cysticercosis can be clearly recognized, the tail of the body or the telescopic activity, and Subarachnoid cysticercosis is basically similar.
2. CT examination showed that the affected extraocular muscles were locally thickened, and those with lump formation showed round or irregular high-density shadows. If the larval body was developed, the calcification was obvious, and sometimes it was difficult to distinguish from inflammatory pseudotumor or other orbital tumors. .
Diagnosis
Diagnosis and differentiation of extraocular muscle cysticercosis
diagnosis
Ask in detail about the history of the history of "rice pork", the history of intestinal mites or other parts of the body with subcutaneous cysticercosis, help the diagnosis of extraocular muscle cysticercosis.
Differential diagnosis
1. Acute extraocular myositis This disease is acute, often monocular, with ptosis and restricted eye movement, prominent eyeballs, eyelid edema, conjunctival hyperemia, edema, etc., may involve optic nerve and visual impairment, CT scan can The appearance of extraocular muscles is mainly caused by thickening of the extraocular muscles, hypertrophy, and obvious end of the myocardium. Ultrasound scanning has no rounded and anechoic dark areas.
2. The orbital pseudotumor is mainly differentiated from myositis-type pseudotumor. This type is characterized by diffuse enlargement of the eye muscle. CT scan shows a single extraocular muscle or multiple extraocular muscles, irregular shape, and dead spots. It is spherically enlarged and is different from the local inflammatory mass shadow caused by the extraocular muscle cysticercosis.
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