Outcome of Abducens Nerve Paralysis in Patients with Nasopharyngeal Carcinoma

Abstract

Abducens is the most common cranial nerve involved in NPC, radiotherapy and or chemotherapy relieves the paralysis in half the patients. Prism correction or botulinum toxin-A injection are effective non-invasive procedures for patients with significant diplopia.

A large‐scale study of the association between biopsy results and clinical manifestations in patients with suspicion of nasopharyngeal carcinoma

“…There was no significant difference in the prevalence of CNI between the noncancerous and cancerous groups (4.3% vs. 7.3%, P = .18; 95% CI, 0.26‐3.718), which may be explained because idiopathic abducens palsy was encountered in most of the benign group. A literature review29–32 and our study both revealed that trigeminal (cranial nerve [CN] V) and abducens (CN VI) are the most common cranial nerves involved in NPC. Li et al29 studied 93 patients who presented with CN palsy at the time of diagnosis of NPC, and found that the cases of CN palsy most commonly involved CN V (38%), CN VI (26%), and CN XII (11%), accounting for the majority of the cases (75%).…”

A Prospective Study of the Causes and Magnetic Resonance Imaging Findings in Adult Isolated Non-traumatic Unilateral Abducens Palsy in Taiwan

“…[12][13][14] Nasopharyngeal carcinoma can invade upwards and backwards through the skull base to the cavernous sinus and middle cranial fossae and invade cranial nerves, the abducens being the most common cranial nerve involved in nasopharyngeal carcinoma. 10,15,16 Therefore, our study has demonstrated that nasopharyngeal carcinoma is a common cause of isolated abducens palsy in adults, which we believe can be applied to populations at increased risk for nasopharyngeal carcinoma, such as the Chinese in Guangdong province in southern China, Hong Kong and Singapore, the Vietnamese, Filipinos, Arabs of North Africa and parts of the Middle East, and the Alaskan Eskimos.…”

Not a microvascular sixth nerve palsy

“…Although nasopharyngeal carcinoma is a relatively uncommon cause of 6th cranial nerve palsy, in a series of 166 patients with nasopharyngeal carcinoma, 28 had cranial nerve involvement at the time of diagnosis, 16 of whom had 6th cranial nerve palsy 9. Certainly, there is an increased incidence of nasopharyngeal carcinoma in Southeast Asia, including the Philippines.…”