인플루엔자B 바이러스 감염 후 발생한 단독 동안신경마비 1례

Acute Isolated Oculomotor Nerve Palsy after Influenza B Virus Infection in a 4-year-old Girl

단독 동안신경마비는 소아에서 매우 드물며 선천성과 외상이 흔한 원인 중 하나이다. 감염 후 발생한 단독 동안신경마비는 인플루엔자 A 바이러스를 포함한 바이러스 질환에서 보고되었으나 소아에서 인플루엔자 B 바이러스와 관련된 보고는 없었다. 본 저자들은 4세 소아에서 인플루엔자 B 바이러스 감염 후 발생한 단독 동안신경마비 1례를 경험하고, 이 증례를 통해 고 용량 스테로이드 치료의 유용성을 제시하고자 하였다.

Isolated oculomotor nerve palsy is very rare in children but if present, congenital disease and trauma are the most common etiologic factors. Post-infectious isolated oculomotor nerve palsy has been identified rarely with several viruses including influenza A virus but not influenza B virus, especially in children. A 4-year-old girl was admitted because of ptosis and ophthalmoparesis of her left eye after influenza B infection. Brain magnetic resonance imaging (MRI) demonstrated diffuse thic-kening of the cisternal segment of the left oculomotor nerve. Laboratory tests were negative for other pathogens or malignancy. She was treated with methylpre dniso-lone pulse therapy because of progressive blepharoptosis and ophthalmopa resis. Within 3 months follow up, the ophthalmoparesis and pupillary abnormalities showed complete recovery, and brain MRI also revealed improvement. Here, we present a case of acute isolated oculomotor nerve palsy after influenza B virus infection.