Estrabismo paralítico: revisão de 24 anos da Santa Casa de São Paulo

Camargo, Gustavo; Hida, Wilson Takashi; Goldchmit, Mauro; Uesugui, Carlos Fumiaki; Souza-Dias, Carlos

doi:10.1590/s0004-27492007000400005

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…In an analysis of existing research on the long-term outcomes of third, fourth, and sixth cranial nerve palsy, we found a diverse landscape of research findings. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Our data corroborates those of previous studies, indicating that abducens nerve palsy is the most frequently encountered among the three nerves, [1][2][3][4][5][6]8,10,11,18 whereas trochlear nerve palsy exhibits a lower prevalence. [1][2][3][4][5][6]8,10 However, recently reported incidence rates in the Korean population present a different perspective, with trochlear nerve palsy being the most common and oculomotor nerve palsy the least common.…”

Section: Discussionsupporting

confidence: 92%

“…As evidenced by various reports in the literature, the incidence of cranial nerve palsy varies among different regions. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Recent reports have indicated that the incidence rates of third, fourth, and sixth cranial nerve palsy among the Korean population are 3.71, 5.73, and 4.66 per 100,000 per year, respectively. 12,14,15 These rates exhibit an age-dependent increase, accelerating notably after individuals reach 60 years of age.…”

Section: Introductionmentioning

confidence: 99%

“…13,18 The causes of these nerve palsies are diverse, encompassing ischemic events, trauma, aneurysms, and compressive lesions. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Intriguingly, the distribution of etiological factors can vary, even within the same institution across different time frames. [1][2][3][4] Moreover, the underlying etiology of these palsies is notably influenced by their clinical course, leading to a spectrum of outcomes that range from complete recovery to a lack of improvement.…”

Section: Introductionmentioning

confidence: 99%

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Retrospective Analysis of Factors Related to the Long-Term Recovery of Third, Fourth, and Sixth Cranial Nerve Palsy with Etiologies and Clinical Course in a Tertiary Hospital

Srimanan,

Panyakorn

2024

OPTH

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Purpose Although various studies have explored the causes and clinical aspects of cranial nerve palsies, there remains a significant gap in understanding the prognostic factors that influence outcomes. In this study, we sought to address this gap by investigating the incidence, etiologies, clinical courses, and factors associated with long-term recovery, with the aim of enhancing the knowledge base in this field and providing valuable insights for improved patient care. Patients and Methods This retrospective study evaluated the data gathered from subjects who had third, fourth, and sixth cranial nerve palsy at the ophthalmology outpatient clinic of Phramongkutklao Hospital between April 1, 2012, and April 30, 2022. Results Among the three nerves, abducens nerve palsy was the most prevalent finding by most commonly involved. Our study revealed that ischemic and compressive lesions were the most common etiology of oculomotor nerve palsy, comprising 24.6% each. In addition, the most common etiology of trochlear and abducens nerve palsy was trauma, at 31.6% and 27.1%, respectively. Compared with the other nerves, oculomotor nerve palsy was associated with a shorter duration onset of symptoms and recovery period. The best recovery outcomes among the various etiologies were inflammation, ischemic events, and trauma in oculomotor, trochlear, and abducens nerve palsy, respectively. Logistic regression revealed that an onset of <7 days and isolated nerve involvement were significantly associated with good long-term outcomes, with an adjusted odds ratio of 1.73 (95% confidence interval, 1.03–2.89) and 2.56 (95% confidence interval, 1.21–5.39) adjusted for the type of cranial nerve palsy, aged at 50 years, sex, diabetes mellitus, hypertension, dyslipidemia, onset at 7 days, and number of cranial nerves involved, respectively. Conclusion The onset of symptoms in less than 1 week and isolated nerve involvement were associated with better prognosis in subjects with third, fourth, and sixth cranial nerve palsy.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retrospective Analysis of Factors Related to the Long-Term Recovery of Third, Fourth, and Sixth Cranial Nerve Palsy with Etiologies and Clinical Course in a Tertiary Hospital

Srimanan,

Panyakorn

2024

OPTH

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“…CN palsies may result from vascular ischemia, hemorrhage, trauma, intracranial neoplasm, systemic neurologic disease, or idiopathic causes. The relative frequency of the different causes may vary slightly according to the studies reviewed [ 1 2 3 ]. Diabetes mellitus and hypertension are among the most frequently reported systemic causes of acquired paralytic strabismus, as they cause ischemic changes in the cerebral nerve [ 4 5 6 7 ].…”

mentioning

confidence: 99%

Clinical Course and Prognostic Factors of Acquired Third, Fourth, and Sixth Cranial Nerve Palsy in Korean Patients

Kim

Noh

Kang

et al. 2018

Korean J Ophthalmol

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PurposeThis study aimed to evaluate the clinical course and prognostic factors of acquired third, fourth, and sixth cranial nerve (CN) palsy grouped according to etiology.MethodsThis study involved a retrospective review of the medical records of 153 patients who were diagnosed with acquired paralytic strabismus from January 2004 to July 2015. Outcomes, recovery rates, and time to recovery were investigated according to the affected CN: CN3, CN4, and CN6 palsies. The patients were classified into four groups based on etiology: idiopathic, traumatic, neoplastic, and vascular.ResultsThe mean age of the patients was 59.8 ± 14.5 years and the mean follow-up period was 10.8 months. Out of the 153 patients, 63 (41.2%) had CN3 palsy, 35 (22.9%) had CN4 palsy, and 55 (35.9%) had CN6 palsy. The most common causes were vascular related (54.9%), followed by idiopathic (28.1%), trauma (8.5%), and neoplasm (5.88%). About 50% of the patients recovered within six months. Among the four etiologic groups, the idiopathic group showed the best prognosis because about 50% of the patients in this group recovered within three months. This was followed by the vascular, traumatic, and neoplastic groups. Cox proportional hazard analysis revealed a significant association between the baseline prism diopter and recovery rate.ConclusionsThe prognosis and natural history of paralytic strabismus vary depending on its cause. The vascular group had the best recovery rate and shortest recovery time, whereas the neoplastic group required the longest time to recover.

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