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Related Experiment Videos

Pediatric third, fourth, and sixth nerve palsies: a population-based study.

J M Holmes1, S Mutyala, T L Maus

  • 1Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA. holmes.jonathan@mayo.edu

American Journal of Ophthalmology
|April 28, 1999
PubMed
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This study found the annual incidence of childhood cranial nerve palsies affecting ocular motility to be 7.6 per 100,000. Congenital causes were most common, and intracranial neoplasia was not an isolated finding.

Area of Science:

  • Ophthalmology
  • Pediatric Neurology
  • Epidemiology

Background:

  • Cranial nerve palsies affecting ocular motility are a significant cause of visual impairment in children.
  • Previous studies have primarily focused on institution-based referral series, potentially limiting generalizability.

Purpose of the Study:

  • To determine the population-based incidence and causes of third, fourth, and sixth cranial nerve palsies in children.
  • To provide epidemiological data from a geographically defined population.

Main Methods:

  • Utilized the Rochester Epidemiology Project medical records linkage system for case identification (1978-1992).
  • Included residents under 18 years of age.
  • Reviewed medical records to confirm diagnoses, ascertain causes, and establish residency.

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Main Results:

  • Identified 36 incidence cases in 35 children over 15 years.
  • Reported an age- and sex-adjusted annual incidence of 7.6 per 100,000 children.
  • Fourth nerve palsy was most common (36%), followed by sixth (33%) and third (22%).
  • Congenital causes predominated for third and fourth nerve palsies; undetermined for sixth; trauma for multiple palsies.

Conclusions:

  • Population-based data offer a more accurate incidence of childhood cranial nerve palsies than referral series.
  • Congenital etiology is more prevalent than previously reported in institutional studies.
  • Intracranial neoplasia did not present as an isolated cranial nerve palsy in this cohort.