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Long-term follow-up of children with benign abducens nerve palsy
1Department of Ophthalmology, University Hospital of Hamburg, Hamburg, Germany. veit_sturm@yahoo.com
Insights
Benign abducens nerve palsy in children is typically painless and resolves within six months. This study confirms its benign nature, with no long-term neurological issues observed in patients.
Area of Science:
- Ophthalmology
- Pediatric Neurology
Background:
- Benign abducens nerve palsy is a rare condition in children.
- Diagnosis requires excluding severe underlying pathologies.
Purpose of the Study:
- To present the largest single-center series of pediatric benign abducens nerve palsy.
- To confirm the benign nature of this condition with extended follow-up.
Main Methods:
- Retrospective study of 12 children with benign abducens nerve palsy.
- Comprehensive orthoptic and ophthalmic examinations during acute presentation and follow-up.
Main Results:
- Palsies were often associated with preceding infection/immunization.
- Recovery occurred within 6 months in all cases; 3 children had ipsilateral recurrences.
- No long-term recurrences or neurological abnormalities were observed during a mean follow-up of over 9 years.
Conclusions:
- Findings support painless, left-sided occurrence, spontaneous recovery, and ipsilateral recurrence.
- Unlike some literature, no female preponderance was found.
- Benign abducens nerve palsy can be considered a benign condition with appropriate exclusion of severe causes and close follow-up.
Purpose:
Benign abducens nerve palsy is rare in childhood. Diagnosis is made by exclusion, and the severe underlying pathologies have to be ruled out. The aim of our study was to present the largest single-center series of patients with the longest period of follow-up to confirm the benign nature of this entity.
Patients And Methods:
We carried out a retrospective study of 12 consecutive children with benign abducens nerve palsy. All children underwent a careful orthoptic and ophthalmic examination during acute presentation and follow-up.
Results:
Painless palsies were associated with a preceding infection or immunization in five patients. The left eye was affected in nine children and no bilateral case was found. No sex differences were seen. Recovery was observed within 6 months in all cases, and ipsilateral recurrences occurred in three children. Three children required strabismus surgery. None of the patients developed long-term recurrences or neurological abnormalities during a mean follow-up of more than 9 years.
Conclusions:
Our data support earlier findings, such as painless and predominately left-sided occurrence, spontaneous recovery within 6 months, and ipsilateral recurrence. In contrast to much of the literature, we did not find a female preponderance. Exclusion of severe causes and close follow-up is mandatory for these patients. As none of the patients developed long-term recurrences or neurological sequelae, this entity can be regarded as a benign condition without malignant associations or complications.