神経学および神経科学ジャーナル

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Clinical Profile and Management of Sixth Nerve Palsy in Paediatric Patients (0-15 Years) in Southern India- a Hospital-Based Study

Iva R Kalita1* ,Veena K2 , Freidrick Mouttappa2 , Priya Sundaralakshmi3

Purpose: This study was done to evaluate the clinical profile in Paediatric patients (0-16 years) presenting with acute onset esotropia due to Sixth Nerve palsy. Methods: A total of 12 patients presenting to our OPD with acute onset esotropia due to sixth nerve palsies were included in this retrospective study. All patients were observed for 6 months and managed with prism and/or patching while waiting for spontaneous resolution and later managed surgically. Neuroimaging was done in all cases. Results: The mean deviation of esotropia at presentation was 30.17 ï?± 5.7 Prism Dioptre( range 12-50 PD, 95% CI, SD 10.11). Mean age of the patients during presentation was 8.6 ï?± 2.4 years(range: 1-15 years, SD 4.27). Among the common causes of sixth nerve palsy in our study population were Trauma and Idiopathic Intracranial Hypertension followed by Tumour and miscellaneous causes. Only 3 patients underwent surgical correction of residual deviation after a waiting period of 6 months for self-resolution. spontaneous resolution was observed in 41.6% patients (table 1) and surgical correction (unilateral resection-recession) was done in 25% of the patients with good surgical outcome. Conclusion: At one-year follow up ,the motor outcome was satisfactory except for one patient who had diffuse pontine glioma and had worsening neurological symptoms on follow-up.