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. 2022 Mar 18;101(11):e29102.
doi: 10.1097/MD.0000000000029102.

Clinical outcomes and etiology of acquired sixth cranial nerve palsy

Shin Yeop Oh  1
Affiliations

Clinical outcomes and etiology of acquired sixth cranial nerve palsy

Shin Yeop Oh. Medicine (Baltimore). .

Abstract

The objective of this study was to investigate the difference in clinical features according to age and factors affecting recovery of acquired sixth cranial nerve (CN6) palsy.A total of 156 patients with acute CN6 palsy between March 2016 and August 2021 who were followed up for at least 3 months were included in this study. Etiology, rate of recovery, and factors associated with recovery were retrospectively investigated.The average age of patients with CN6 palsy was about 60years and the mean duration of recovery was about 2.5 months. Of 156 patients, 72 (46.15%) had a microvascular etiology and 25 (16.03%) patients had a brain vascular lesions. Brain neoplasm, trauma, and "others" were found in 10 (6.41%), 11 (7.05%), and 15 (9.62%) patients, respectively. Among the total of 156 patients, 28 (17.95%) failed to completely recover. Non-isolated CN6 palsy with other cranial nerve palsies were recorded in 29 (18.59%) cases. Comparison of age (<50years vs ≥50years), between recovery and non-recovery groups showed that etiology was significantly different.The recovery rate of acquired CN6 palsy was about 82% and about 27% of patients had brain lesions. Also, varying rates and duration of recovery were found according to etiology, so we should be pay attention to diagnosis of causative disease in CN6 palsy patients.

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Conflict of interest statement

No conflicting relationship exists for any author.

Figures

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Figure 1. Etiology of sixth cranial nerve palsy in 156 patients.
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Figure 2. Twenty-eight-year-old female patient with right sixth cranial nerve palsy due to carotid-cavernous fistula. (A) On axial T1 weighted image, a prominent enhanced right cavernous sinus and exophthalmic state of right orbit were observed. (B) Right cerebral angiography showing carotid-cavernous fistula with dilated superior ophthalmic vein.
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Figure 3. Forty-three-year-old female patient with right third, fourth, and sixth cranial nerve palsy due to Tolosa-Hunt syndrome. On axial T1 weighted image, a focal triangular shaped contrast enhancement in right cavernous sinus was observed.
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Figure 4. Etiology of sixth cranial nerve palsy according to age groups.
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Figure 5. Etiology of sixth cranial nerve palsy in recovery group and non-recovery group.
See this image and copyright information in PMC

References

    1. Elder C, Hainline C, Galetta SL, Balcer LJ, Rucker JC. Isolated abducens nerve palsy: update on evaluation and diagnosis. Curr Neurol Neurosci Rep 2016;16:69. - PubMed
    1. Tamhankar MA, Biousse V, Ying GS, et al. Isolated third, fourth, sixth cranial nerve palsies from presumed microvascular versus other cause: a prospective study. Ophthalmology 2013;120:2264- 9. - PMC - PubMed
    1. Park US, Kim SJ, Hwang JM, Yu YS. Clinical features and natural history of acquired third, fourth, sixth cranial nerve palsy. Eye (Lond) 2008; 22:691- 6. - PubMed
    1. Jung EH, Kim SJ, Lee JY, Cho BJ. The incidence and etiology of sixth cranial nerve palsy in Koreans: a 10-year nationwide cohort study. Sci Rep 2019;9:18419. - PMC - PubMed
    1. Swati P, Rebika D, Sharma M, et al. Acquired ocular motor palsy: current demographic and etiological profile. Asia Pac J Ophthalmol (Phila) 2020;9:25- 8. - PMC - PubMed