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Pediatric ocular motor cranial nerve palsy: Demographics and etiological profile

Sweksha Priya1, Sujata Guha1, Shruti Mittal1

  • 1Department of Pediatric Ophthalmology and Strabismus, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya, Kolkata, (A Unit of Medical Research Foundation, Chennai, Tamil Nadu, India), India.

Indian Journal of Ophthalmology
|April 29, 2021
PubMed

Insights

Pediatric ocular motor cranial nerve palsy most commonly involves the third nerve and is associated with amblyopia. Congenital causes are frequent, with trauma noted for sixth nerve palsy.

Area of Science:

  • Ophthalmology
  • Neurology
  • Pediatrics

Background:

  • Ocular motor cranial nerve palsy in children can lead to significant visual impairment.
  • Understanding the epidemiology and clinical features is crucial for effective management.

Purpose of the Study:

  • To describe the epidemiological and clinical characteristics of pediatric ocular motor cranial nerve palsy.
  • To identify common etiologies, associated conditions like amblyopia, and management strategies.

Main Methods:

  • Retrospective record-based study conducted at a tertiary eye care hospital in India.
  • Included 90 pediatric patients (up to 16 years) with third, fourth, or sixth cranial nerve palsy.
  • Data analyzed included demographics, etiologies, amblyopia, investigations, and management.

Main Results:

  • Third cranial nerve palsy was most common (38.88%), often congenital.
  • Congenital causes predominated for third and fourth nerve palsies; trauma for the sixth nerve.
  • Amblyopia was most frequent with third nerve palsy (77.14%).
  • Neuroimaging yield was highest for combined cranial nerve palsies (70%).

Conclusions:

  • The third cranial nerve is the most frequently affected ocular motor nerve in children and the most amblyogenic.
  • Combined cranial nerve palsies show the highest diagnostic yield with neuroimaging.
  • Fourth nerve palsy was most commonly managed conservatively.
Abstract

Keywords:
Cranial nerve palsyparalytic squintpediatric cranial nerve palsy

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