Related Experiment Videos
Sixth cranial nerve palsy following closed head injury in a child
1Department of Emergency Medicine, St George Hospital, Kogarah, NSW, Australia.
Insights
Traumatic abducens nerve palsy in children can occur after head injuries, even without fractures. Most cases resolve within six months, but persistent palsy may require surgery.
Area of Science:
- Ophthalmology
- Neurology
- Pediatric Traumatology
Background:
- Isolated abducens nerve palsy (sixth cranial nerve palsy) can result from closed head injuries in children.
- This type of injury is significant due to potential visual impairment and the need for accurate diagnosis.
Observation:
- A five-year-old female presented with isolated abducens nerve palsy post-head injury.
- No associated skull fractures, hematomas, or other cranial nerve injuries were noted.
Findings:
- Traumatic sixth cranial nerve injury is discussed concerning its significance, frequency, and differential diagnosis in pediatric patients.
- Management is primarily symptomatic, with eye patching for significant diplopia.
- Alternate-day patching in young children can prevent amblyopia.
Implications:
- Most traumatic abducens nerve palsies improve within three to six months.
- Persistent palsy after six months suggests a permanent condition requiring consideration for surgical intervention.
- Early recognition and management are crucial for optimal visual outcomes in pediatric head injury patients.
Abstract:
A five year old female had an isolated abducens nerve palsy following closed head injury. There was no associated skull fracture, haematoma, or other cranial nerve injury. The significance, frequency, and differential diagnosis of traumatic sixth cranial nerve injury is discussed, particularly in paediatric patients. Management is symptomatic; occlusion with an eye pad may be used if diplopia is significant. In young children alternate day occlusion of each eye will help prevent amblyopia. Most cases improve within three months and many resolve by six months. Residual palsy at six months is likely to be permanent and surgical treatment may be needed.