Acupuncture for abducens nerve palsy after radiochemotherapy: a CARE-compliant case report

Delayed abducens nerve palsy after chemoradiotherapy for nasopharyngeal carcinoma (NPC) is often accompanied by ocular ischemia and cranial nerve damage, thereby increasing the risk of conventional strabismus surgery. Therefore, patients often prefer conservative treatment. Herein we report a case of acupuncture for delayed abducens nerve palsy after chemoradiotherapy for NPC.

A 39-year-old patient who previously received chemotherapy and radiotherapy for NPC developed a unilateral abducens nerve palsy with numbness in the face and stiffness in the neck muscles after six years. Based on magnetic resonance imaging (MRI), medical history, and physical examination, he was diagnosed with abducens nerve palsy after chemoradiotherapy. The acupuncture treatment regimen was mainly based on periocular electroacupuncture, supplemented with wheat grain moxibustion and warming needle moxibustion, which were performed three times a week. After one month with a total of 17 acupuncture sessions, the patient's affected eye abduction function recovered completely. Facial sensory abnormalities and neck stiffness also improved significantly. Follow-up at two months reported no recurrence.

Acupuncture may be a conservative treatment option for patients with abducens nerve palsy after chemoradiotherapy.