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Clinical features and natural history of acquired third, fourth, and sixth cranial nerve palsy

Cited 53 time in Web of Science Cited 61 time in Scopus
Authors
Park, U-C; Kim, S-J; Hwang, J-M; Yu, Y S
Issue Date
2007-02-13
Publisher
Nature Publishing Group
Citation
Eye 2008; 22(5): 691-696
Keywords
Abducens Nerve Diseases/*etiology/physiopathologyAdolescentAdultAgedAged, 80 and overChildChild, PreschoolCraniocerebral Trauma/complicationsEye Neoplasms/complicationsFemaleFixation, Ocular/physiologyHumansInfantMaleMiddle AgedMultivariate AnalysisOculomotor Nerve Diseases/*etiology/physiopathologyPrognosisRetrospective StudiesTrochlear Nerve Diseases/*etiology/physiopathologyVascular Diseases/complicationsYoung Adult
Abstract
PURPOSE: Clinical features of acquired third, fourth, and sixth cranial nerve palsy showed variation among previous studies. Evaluation of natural course with objective criteria will establish accurate recovery rates and important factors for recovery. METHODS: Retrospective chart review was performed on 206 patients who visited a neuro-ophthalmic department with acquired third, fourth, and sixth nerve palsy. Aetiology and results of ocular exam on each visit were reviewed, and multivariate logistic regression analysis was performed to identify independent factors affecting recovery. RESULTS: The sixth cranial nerve was affected most frequently (n=108, 52.4%) and vascular disease (n=64, 31.1%) was the most common aetiology. Recovery was evaluated with change of deviation angle for 108 patients, who were first examined within a month of onset and followed up for at least 6 months. Ninety-two (85.2%) patients showed overall (at least partial) recovery and 73 (67.6%) showed complete recovery. In univariate analysis, initial deviation angle was found to be only significant factor associated with complete recovery (P=0.007) and most patients who experienced successful management of treatable underlying disease showed recovery. CONCLUSIONS: With objective criteria based on deviation angle, overall recovery rate from the third, fourth, and sixth nerve palsy was 85.2%. Patients who had smaller initial eyeball deviation or successful management of treatable underlying disease had a high chance of recovery.
ISSN
0950-222X (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17293794

http://www.nature.com/eye/journal/v22/n5/pdf/6702720a.pdf

http://hdl.handle.net/10371/68249
DOI
https://doi.org/10.1038/sj.eye.6702720
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College of Medicine/School of Medicine (의과대학/대학원)Ophthalmology (안과학전공)Journal Papers (저널논문_안과학전공)
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