Acute Abducens Nerve Paralysis in the Pediatric Emergency Department

Tekşam, Özlem; Gültekingil, Ayşe; Konuşkan, Bahadır; Haliloğlu, Göknur; Oğuz, Kader Karlı; Yalnızoğlu, Dilek

doi:10.1097/pec.0000000000000366

Cited by 8 publications

(5 citation statements)

References 16 publications

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“…Abducens nerve palsy clinically presents with diplopia, inward deviation of the eye and difficulty with lateral ocular movement. Accompanying symptoms such as headache, vomiting, unstable gait and fever may be present depending on the palsy's etiology (15).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Unilateral Sixth Cranial Nerve Palsy Associated With COVID-19 in a 2-year-old Child

et al. 2021

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Children have been described to show neurological symptoms in acute coronavirus disease 2019 (COVID-19) and multisystemic inflammatory syndrome in children (MIS-C). We present a 2-year-old boy's clinical course of unilateral acute sixth nerve palsy in the context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Onset of the palsy in the otherwise healthy boy occurred seven days after symptoms attributed to acute infection had subsided respectively 3 weeks after onset of respiratory symptoms. SARS-CoV-2 specific IgG was detected in serum as well as in cerebrospinal fluid. The patient showed a prolonged but self-limiting course with a full recovery after three and a half months. This case illustrates in a detailed chronological sequence that sixth cranial nerve involvement may occur as post-infectious, self-limiting complication of pediatric SARS-CoV-2-infection thus expanding the neurological spectrum of symptoms for children with COVID-19. Clinicians should be aware of the possibility of post-infectious sixth nerve palsy related to SARS-CoV-2-infection particularly in view of recent respiratory tract infection or confirmed cases of SARS-CoV-2-infection amongst the patient's close contacts.

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Section: Discussionmentioning

confidence: 99%

Case Report: Unilateral Sixth Cranial Nerve Palsy Associated With COVID-19 in a 2-year-old Child

et al. 2021

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“…7 Considering that benign abducens nerve palsy in children may be caused by immune-mediated nerve injury, we treated both patients with methylprednisone, gamma globulin, and vitamin B for nerve nutrition, and their clinical symptoms gradually improved. Some studies 3 also claim that the disease itself is self-limited and does not require specific treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Lee et al 2 analyzed the causes of abducens nerve palsy in children and concluded that tumors and related neurosurgery were the most common causes (45%), followed by elevated intracranial pressure (15%), traumatic brain injury (12%), congenital causes (11%), inflammation (7%), other causes (5%), and idiopathic causes (5%). It has also been reported that Guillain-Barre syndrome 3 and upper respiratory infections 3 can lead to abducens nerve palsy. Benign abducens nerve palsy has a low incidence in children, and its diagnosis relies on the exclusion of other diagnoses.…”

Section: Introductionmentioning

confidence: 96%

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Two cases of benign abducens nerve palsy in children and their long-term follow-up

Zhang

Tang

2021

J Int Med Res

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Our aim was to explore the clinical characteristics and diagnostic methods of benign abducens nerve palsy in children. The clinical and laboratory characteristics, treatment approach, and prognosis of two children with benign abducens nerve palsy were retrospectively evaluated. The main clinical symptoms of the two children were limited binocular movement accompanied by double vision, and the positive physical signs were limited binocular abduction accompanied by diplopia. No abnormalities were found in laboratory examinations or in imaging of the head, chest, and abdomen. Both children were treated with B vitamins, methylprednisolone, and gamma globulin, and the clinical symptoms disappeared within 3 months of starting treatment. The cause of benign abducens nerve palsy in children is unknown, but may be related to immune factors. In the two cases presented here, the patients recovered after treatment with immunomodulators.

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“…Similar to adults, isolated sixth (6th) nerve palsy is the most common cranial nerve palsy in the pediatric population [ 1 ]. However, it is far less frequent in children and demands an immediate and thorough investigation, due to potentially devastating common causes in these ages, such as trauma, neoplasms, central nervous system infection, or raised intracranial pressure [ 2 , 3 ]. Benign causes account for just 9 to 14% of all 6th nerve palsies in children [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Benign Recurrent Sixth Nerve Palsy in a Child

Gonçalves

Coelho

Menezes

et al. 2017

Case Reports in Ophthalmological Medicine

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Benign recurrent sixth nerve palsy in children is rare. It typically occurs following viral illness or immunization, and prognosis is usually excellent. However, it is always a diagnosis of exclusion given the more serious alternative causes. Therefore, a thorough examination with brain imaging is recommended. The authors report a child with six recurrent episodes of isolated benign sixth nerve palsy.

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Acute Abducens Nerve Paralysis in the Pediatric Emergency Department

Cited by 8 publications

References 16 publications

Case Report: Unilateral Sixth Cranial Nerve Palsy Associated With COVID-19 in a 2-year-old Child

Case Report: Unilateral Sixth Cranial Nerve Palsy Associated With COVID-19 in a 2-year-old Child

Two cases of benign abducens nerve palsy in children and their long-term follow-up

Benign Recurrent Sixth Nerve Palsy in a Child

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