本研究旨在通过长期随访的疼痛性眼肌麻痹患者确定最终明确的病因。检查了44例（女性16例，女性28例）的数据。在第一次诊断中，对受试者进行良性和继发性病因扫描。记录患者的临床和放射学随访结果。在随访期间，评估了临床结果（复发或进展）、治疗反应和最终诊断的数据。总共评估了 49 次眼肌麻痹疼痛发作（44 名患者）。 21 名患者中确定了继发性病因，其中良性/继发性肿瘤原因 10 例，炎症性 10 例，感染性 3 例，血管性 3 例，脱髓鞘疾病 1 例，自身免疫性 2 例，药物相关原因 1 例。良性病因 23 例； 11 人患有 Tolosa-Hunt 综合征 (THS)，2 人患有复发性疼痛性眼肌麻痹神经病 (RPON)，10 人患有糖尿病性眼肌麻痹 (DO)。 11 名 THS 患者中有 7 名符合国际头痛疾病分类第三版 (ICHD-3 beta) 标准，4 名 MRI 正常，1 名复发。 10名良性/继发性肿瘤患者中有9名是恶性肿瘤，7名患者在治疗过程中因病情进展而死亡。十名患者中的一名患有糖尿病性眼肌麻痹，并因随访期间的临床进展而被诊断为 B 细胞淋巴瘤海绵窦受累。疼痛性眼肌麻痹是一种复杂的临床病症，具有广泛的恶性和良性病因鉴别诊断。详细的临床检查、影像学和长期随访对于准确的诊断和治疗管理至关重要。© 2024 Taylor

This study aims to establish the final definite etiology among patients with long-term follow-up for painful ophthalmoplegia. The data of 44 cases (16 females, 28 females) were examined. In the first diagnosis, subjects were scanned in terms of benign and secondary etiologies. Clinical and radiological follow-up results of patients were recorded. During the follow-up period, data on clinical outcomes (relapse or progression), treatment responses, and final diagnoses were evaluated In total, 49 episodes of painful ophthalmoplegia (44 patients) were evaluated. Secondary etiologies were identified in 21 patients benign/secondary tumours causes in 10, inflammatory in 1, infectious in 3, vascular in 3, demyelinating disease in 1, autoimmune in 2, drug-related cause in 1. 23 patients with benign etiologies; 11 had Tolosa-Hunt syndrome (THS), 2 had Recurrent Painful Ophthalmoplegic Neuropathy (RPON), and 10 had diabetic ophthalmoparesis (DO). 7 of 11 patients with THS met the International Classification Headache Disorders 3rd edition (ICHD-3 beta) criteria, 4 were with a normal MRI, and 1 had a recurrence. 9 of 10 patients with benign/secondary tumours causes were malignant, and 7 died due to disease progression during the treatment process. One of ten patient was followed with diabetic ophthalmoparesis and was diagnosed with cavernous sinus involvement of B-cell lymphoma as a result of clinical progression during follow-up. Painful ophthalmoplegia is a complex clinical condition with a broad differential diagnosis with malignant and benign etiologies. A detailed clinical examination, imaging, and long-term follow-up are essential for accurate diagnosis and treatment management.© 2024 Taylor & Francis Group, LLC.