Botulinum toxin treatment of "one and a half syndrome"

Kipioti, Athina

doi:10.1136/bjo.87.7.918-a

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…Menon [47] reported that botulinum administration was beneficial for some of a small series of patients with external ophthalmoplegia. A single case of internuclear ophthalmoplegia with oscillopsia was successfully treated with botulinum [48]. The follow-up in this case was limited to 3 months.…”

Section: Ophthalmoplegiamentioning

confidence: 94%

Use of botulinum toxin in strabismus

Crouch

2006

Current Opinion in Ophthalmology

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Botulinum administration is a strabismus treatment option that may be considered for some strabismus patients; in select cases botulinum is a reasonable and preferable alternative to surgery. Current clinical recommendations regarding botulinum should be considered in the context of the existing comparative studies that are summarized in this review. Since there are very limited data directly comparing the success rates of botulinum with standard strabismus surgery, additional, well designed prospective studies are needed. Data from such studies would enable recommendations for strabismus management to be formulated using an evidence-based approach.

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Section: Ophthalmoplegiamentioning

confidence: 94%

Use of botulinum toxin in strabismus

Crouch

2006

Current Opinion in Ophthalmology

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“…There are four reports using BTA. [6][7][8][9] One case concluded a permanent improvement of the symptoms in a one-and-a-half syndrome following BTA injection into lateral rectus; however the injection was given soon after the vascular accident and may have masked natural improvement. Surgical treatment of these conditions is confined to a few papers.…”

Section: Discussionmentioning

confidence: 94%

Surgical Treatment of Internuclear Ophthalmoplegia and its Variants

Durnian¹,

Jazayeri²,

Trimble³

et al. 2009

Neuro-Ophthalmology

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The purpose of this study is to describe the surgical management of internuclear ophthalmoplegia (INO) and its variants. This is a retrospective, noncomparative, observational study of 15 surgical procedures on thirteen patients with symptoms attributed to INO which were conducted between December 1993 and October 2006. Surgical management was decided on the results of orthoptic measurements and tailored to each individual patient. In this group of 13 patients there were 4 cases of 'wall-eyed' bilateral INO (WEBINO) syndrome, 6 cases of bilateral INO with intact convergence and 3 cases of unilateral INO. The commonest indication for surgery was diplopia, either in primary or immediate lateral gaze, in 12 cases. The mean length of symptoms was 61 months (range 12 to 180). The mean angle of deviation pre-operatively was 25.7 prism diopters (PD) base-in (BI). Bilateral lateral rectus (LR) recession was used in 9 cases. Unilateral LR recession combined with medial rectus (MR) resection was performed in 2 cases. The remaining 4 cases had a unilateral LR recession. The mean post-operative angle of deviation was 11.6PD BI. The mean change in deviation was 14.6 PD. There were no intra-or post-operative surgical complications. Incomplete symptomatic relief in 2 patients necessitated a second surgical procedure. At final review all patients were asymptomatic. Surgery is an option that should be considered in all patients with an incompletely resolved INO. All our patients had complete relief from their symptoms. In the hands of an experienced strabismus surgeon, the surgery is routine. We show that patients who are willing for surgical intervention wait an average of 5 years for surgery and could be offered surgery more quickly.

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“…Treatments include, but are not limited to, corticosteroids, immunomodulatory agents and plasmapheresis in autoimmune diseases, thiamin in Wernicke encephalopathy, and surgery or radiation therapy in cases of tumours and arteriovenous malformations. Also, lumbar puncture, the injection of botulinum toxin and supportive treatments have been suggested in some conditions [8,9]. Martyn et al reported an MS patient with one-and-a-half syndrome who was managed with dexamethasone.…”

Section: To the Editorsmentioning

confidence: 99%