Traumatic Bilateral Abducens Nerve Palsy
DOI:
https://doi.org/10.48560/rspo.24346Keywords:
Abducens Nerve Injury/drug therapy, Botulinum Toxins/therapeutic useAbstract
Introduction: Our purpose was to report a case of severe traumatic bilateral sixth nerve palsy. We describe a clinical case documented with photographs on different gazes; Hess screen charts and Goldmann visual field tests over time.
Case Report: A 42-year-old male was involved in a high-energy car crash (240 km/h). Nine days after, when transferred to our hospital, he presented with severe bilateral sixth nerve palsy, with limitation in the abduction of right and left eye, without crossing the midline. He was submitted to 3 rounds of medial rectus botulinum toxin (BTX) injections. The first done 1 month and the last 6 months after the accident. He achieved good results with no diplopia and no abduction limitations.
Conclusion: Although the bilateral involvement and the severity of the abduction deficit in sixth nerve palsy are independently associated with a poor outcome, our clinical case had a good outcome with total and definitive recuperation of severe bilateral palsy after medial rectus BTX injections started in the acute phase.
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