Physiotherapy in Postinfection Injury to Cranial Nerves III, IV, and VI

Abstract

The patient with bacterial infection sequelae in the form of damage to cranial nerves III, IV, and VI was followed up. He had exhibited clinical and radiographic signs of paranasal sinusitis. Before his physiotherapy, the patient received standard treatment with natural and synthetic antibiotics and steroids. After acute signs of infection resolved without any functional improvement, the patient was referred to a rehabilitation unit to undergo neuromuscular re-education of the paralyzed extraocular muscles. Periorbital hydrocortisone iontophoresis and visuomotor exercises with intense ideomotor stimulation led to complete and rapid resolution of extraocular muscle paralysis and diplopia. Physiotherapy can be an effective treatment of choice after failed pharmacological treatment in patients with damage to cranial nerves III and VI. It has many theoretical advantages, including noninvasiveness and avoidance of first-pass metabolism of drugs administered systemically.

Managemen Fisioterapi Pada Kasus Lesi Saraf Okulomotor Unilateral: A Case Report

“…Infrared memberikan efek vasodilatasi yang akan memperlancar peredaran darah dan diharapkan dapat memberikan supply oksigen yang cukup pada saraf (de Oliveira et al, 2021), selanjutnya electrical stimulation menggunakan arus faradic diharapkan dapat menimbulkan pergerakan otot sehingga mampu memfasilitasi gerakan dan meningkatkan kekuatan otot kelopak mata. Salah satu indikasi dari electrical stimulation ini adalah meningkatkan kemampuan otot yang mengalami kelemahan otot karena gangguan saraf, dan perbaikan jaringan (Rongies et al, 2018). Sedangkan eye exercise berfungsi untuk menguatkan otot mata, membantu mata lebih focus, melancarkan pergerakan otot atau bola mata, dan merangsang bagian otak yang mengatur penglihatan (Watabe et al, 2019).…”