The role of Botulinum toxin in management of acute traumatic third-nerve palsy.

Abstract

PURPOSE:

To study the effect of botulinum toxin A injection in the management of paralytic exotropia resulting from acute traumatic third (oculomotor) nerve palsy.

METHODS:

Nine patients with acute traumatic partial third-nerve palsy of less than 2 months' duration were treated by injection of botulinum toxin A into the ipsilateral lateral rectus muscle. The horizontal deviation angles before and after the injections were recorded. A distance exotropia of less than 10(Delta) or absence of diplopia in the primary position at the last follow-up was defined as recovery.

RESULTS:

The mean preinjection deviation in the primary position was 48.3(Delta) of exotropia, and the mean postinjection deviation in the primary position was 14.2(Delta) at the last follow-up. Seven patients experienced recovery and regained single binocular vision in the primary position. The overall recovery rate was 77.8%. Two patients did not recover and subsequently underwent strabismus surgery.

CONCLUSIONS:

Patients with acute traumatic partial third-nerve palsy treated by injection of botulinum toxin A in the lateral rectus muscle showed marked recovery when injection was performed within 2 months of the onset of palsy. Botulinum toxin injection into the lateral rectus muscle may provide temporary relief of symptoms in some patients and seems to be a useful treatment option in cases of acute traumatic third nerve palsy in the short-term.

• Authors: Mohammad Reza Talebnejad, Mohammad Sharifi, Mohammad Hosein Nowroozzadeh
• Journal: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) Vol. 12 Issue 5 Pg. 510-3 (Oct 2008) ISSN: 1528-3933 [Electronic] United States
• PMID: 18558505 (Publication Type: Journal Article)

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Adult
• Botulinum Toxins, Type A (administration & dosage, therapeutic use)
• Craniocerebral Trauma (complications)
• Drug Administration Schedule
• Exotropia (etiology, physiopathology, surgery)
• Humans
• Injections, Intramuscular
• Male
• Neuromuscular Agents (administration & dosage, therapeutic use)
• Oculomotor Muscles (drug effects)
• Oculomotor Nerve Diseases (complications, drug therapy, etiology)
• Recovery of Function
• Retreatment
• Vision, Binocular
• Young Adult