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Causes and treatment outcomes of third, fourth and sixth cranial nerve palsy
Thammanoon Surachatkumtonekul1, Pennapa Soontrapa, Suchada Kampanartsanyakorn
1Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand. sitsr@mahidol.ac.th
Objective:
To evaluate the causes and the treatment outcomes of third, fourth and sixth cranial nerve palsy
Material And Method:
Medical records of 157 cases with extra-ocular muscle palsy from third, fourth or sixth cranial nerve palsy between January 1995 and December 2009 were reviewed. Demographic data, age, causes of extra-ocular muscle palsy and treatment outcomes were record and analyzed. The patients who were followed-up less than 6 months, myasthenia gravis and extra-ocular muscles fibrosis were excluded from the present study.
Results:
One hundred and fifty-seven cases from 600 cases were included in the present study. The most common cranial nerve palsy was the sixth cranial nerve with 63 cases (40.1%). Of 157 cases, the causes were trauma 41 cases (26.1%), microvascular occlusion cause 34 cases (21.7%) and congenital cause 21 cases (13.4%). Cranial nerve palsy patients from microvascular occlusion cause spontaneously improved 25 of 34 cases (73.50%) in 6 months. All patients (21 cases)from congenital cranial nerve palsy had extra-ocular muscle surgery and 17 patients (80.9%) were successful.
Conclusion:
Sixth cranial nerve palsy was the most common cranial nerve palsy. Most patients with cranial nerve palsy from vascular cause spontaneously improved in 6 months. Congenital cranial nerve palsy patients need extra-ocular muscle surgery and most cases were successful
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