The common features of extraocular muscle paralysis syndrome are: ptosis and gradual blockage of eye movement in both eyes or in one eye, and in some patients even eye fixation, bilateral pupil movement is not affected, and multiple eye muscles are denervated. In some cases, the eye is fixed, bilateral pupil movement is not affected, and multiple eye muscles become uninervated. The most common are senile ptosis, painful ophthalmoplegia, ophthalmoplegic migraine, intracranial aneurysm, and diabetic ophthalmoplegia. 1. Age-related ptosis: ptosis of the upper eyelid, obvious in the evening and fatigue, with family history. 2, painful ophthalmoplegia syndrome: also known as Tolosa-Hunt syndrome, clinical features: 1) symptoms of ophthalmoplegia are often accompanied by postocular pain, and radiates to the temporal and prefrontal areas; 2) lesions often involve the third, fourth and sixth cerebral nerves, the first branch of the fifth cerebral nerve and sympathetic nerves; 3) symptoms can last for several days or months, and can resolve on their own, a few patients can remain part of the nerve paralysis symptoms; 4) the time interval of the onset varies, and can be different. 4) The time interval between attacks varies and can be months or years; 5) There are no systemic abnormalities except for the supraorbital fissure of the cavernous sinus; 6) Adrenocorticotropic hormone can promote the relief of symptoms. The pathological basis of painful ophthalmoplegia syndrome is a nonspecific inflammation or sarcoidosis of the supraorbital fissure or the sinus area of the sea surface, which can be manifested by supraorbital lobar or nodular granulomatous hyperplasia on MRI, or by enlargement and widening of the cavernous sinus. The disease may recur. The first symptom was persistent orbital pain on one side with nausea, vomiting and ipsilateral frontotemporal pain, which was diagnosed as “trigeminal neuralgia” and “glaucoma”. CT and MRI examination did not show any abnormality; treated with adrenocorticosteroids, mannitol, antibiotics and analgesics for 1 week. Diabetic ophthalmoplegia: diabetic neuropathy is one of the common complications of diabetes mellitus, the incidence of which can reach 10% – 15%, cranial nerve involvement accounts for 0.7% – 1.0% of the complications of the diabetic nervous system, diabetic ophthalmoplegia occurs mostly in middle-aged and elderly people, the incidence of diabetic ophthalmoplegia increases with age and the prolongation of the disease, and the disease can also recur. Among the 9 cases in this paper, 4 cases had incomplete motoneurysmal nerve palsy, 2 cases had talocalcaneal nerve palsy, and 3 cases had abnormal abnormal abnormalities in most neurological examinations. 4. Oculomotor palsy migraine: There may be a history of recurrent migraine attacks, but the pain in the orbit and behind the ball is the most severe. In this paper, a middle-aged female presented with headache and ptosis with diplopia for 2 months and 1 week; she had a history of migraine and had a history of the same disease 8 years ago, which improved with acupuncture and blood-strengthening medicine; physical examination and diplopia suggested palsy of the first branch of the motoneurotic nerve, abducens nerve and trigeminal nerve. 5, intracranial aneurysm intracranial aneurysm to intracarotid – posterior communicating artery aneurysm compression in this penetration of the articulating nerve, this is the case in this paper, the damage is often complete articulating nerve paralysis. Diagnosis of intracranial aneurysm: Aneurysm should be considered first in middle-aged and older patients with 1) migraine attack with paralysis of one eye muscle; 2) sudden paralysis of one articular nerve or abducens nerve; 3) sudden subarachnoid hemorrhage; 4) recurrent massive nasal bleeding with progressive loss of vision on one side. The symptoms of aneurysm may vary depending on the location of the aneurysm, and the diagnosis depends on MRA, CTA or DSA. Cases: Among the 15 patients, 9 were male and 6 were female; age ranged from 46 to 78 years, with an average of 59 years; 9 had a history of diabetes mellitus, 1 had a history of migraine, and 4 had a history of hypertension. There were 9 cases with complaints of diplopia, 6 cases with blurred vision and headache, 2 cases with nausea and vomiting, 4 cases with small eye fissures, and 3 cases with recurrent remission. There were 6 cases of pure motoneural nerve palsy, 3 cases of abducens nerve palsy, 2 cases of talipes nerve palsy, and 4 cases of multicranial nerve palsy. All of them were monocular, 9 cases in the right eye and 6 cases in the left eye. All patients underwent ophthalmologic review, fundus, intraocular pressure, and general ophthalmologic examination; laboratory tests such as routine blood count, blood glucose, blood lipids, liver function, and kidney function; and imaging tests such as cranial CT, MRI, and DSA if necessary. To clarify the cause of extraocular muscle paralysis and its etiology.