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Etiology and treatment of pediatric sixth nerve palsy

Pilar Merino1, Pilar Gómez de Liaño, Jose Miguel Caro Villalobo

  • 1Hospital General, Universitario Gregorio Marañón, Madrid, Spain. pilimerino@gmail.com

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|December 21, 2010
PubMed

Insights

Neoplasms are a common cause of sixth (abducens) nerve palsy in children. While some cases resolve spontaneously, botulinum toxin treatment is often successful, with surgery needed only in persistent cases.

Area of Science:

  • Ophthalmology
  • Pediatric Neurology
  • Strabismus

Background:

  • Sixth (abducens) nerve palsy affects eye movement control in children.
  • Understanding causes and effective treatments is crucial for pediatric ophthalmologists.

Purpose of the Study:

  • To investigate the etiologies and treatment outcomes of sixth nerve palsy in pediatric patients.
  • To evaluate the efficacy of botulinum toxin and subsequent surgical interventions.

Main Methods:

  • Retrospective analysis of 15 pediatric patients diagnosed with sixth nerve palsy over 14 years.
  • Assessment of horizontal deviation, abduction limitation, and head turn.
  • Treatment with botulinum toxin, with surgery reserved for treatment failures.

Main Results:

  • Neoplasm was the most frequent cause (4/15 cases), often with other neurological signs.
  • Spontaneous recovery occurred in 5 patients.
  • Botulinum toxin achieved success in 70% of treated patients (7/10), with 3 requiring surgery.
  • All patients achieved a good final outcome with a mean resolution time of 39 months.

Conclusions:

  • Neoplasms represent a significant cause of pediatric sixth nerve palsy.
  • Botulinum toxin is an effective primary treatment, minimizing the need for surgery.
  • Early diagnosis and appropriate management lead to favorable outcomes in pediatric sixth nerve palsy.
Abstract

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