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

Zhang, Tong; Tang, Jihong

doi:10.1177/0300060520986702

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…First, immunization or a viral infection may trigger an autoimmune response that leads to demyelination or localized arteritis, which causes sixth nerve palsy. 13 14 Second, there have been speculations toward an association with vaccine additives. However, this is judged to be unlikely by other authors.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Isolated Sixth Nerve Palsy in Childhood—Review on a Rare Phenomenon

Kingma

Ceulemans

2022

Neuropediatrics

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Sixth nerve palsy is an ominous sign in pediatric neurology. Due to the long and tortuous course of the sixth (abducens) nerve, it is generally considered a sign of intracranial pathology. Sixth nerve palsy is associated with increased intracranial pressure and neoplasms, among other less frequent causes. In ∼5 to 15% of cases, no cause can be identified. These cases are classified as idiopathic or “benign” and recovery is typically complete. A recurrence of symptoms is very rare. We provide a rare case report of recurrent benign sixth nerve palsy in a 5-year-old child. In addition, we provide an overview of all earlier published cases of recurrent isolated sixth nerve palsy. To date, only 72 pediatric patients with recurrent isolated sixth nerve palsy have been reported. Young females with left-sided sixth nerve palsy and recent immunization are at risk of recurrence. Pathophysiological mechanisms have been discussed, but have yet to be clarified. Recurrent isolated sixth nerve palsy is only rarely associated with severe causes and the need for extensive investigation may be questioned.

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Section: Discussionmentioning

confidence: 99%

Recurrent Isolated Sixth Nerve Palsy in Childhood—Review on a Rare Phenomenon

Kingma

Ceulemans

2022

Neuropediatrics

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“…No anti-inflammatory treatment was initiated; clinical symptoms gradually subsided and were thus self-limiting. Experience from similar courses related to other (suspected) post-infectious cranial nerve palsies has demonstrated that immunomodulators such as glucocorticoids or immunoglobulins might be a pharmacological treatment option (28,29).…”

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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Sixth nerve palsy post covid treated with course of oral steroids

Caculo,

Murthy,

Willy

et al. 2024

Kerala Journal of Ophthalmology

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Severe acute respiratory syndrome corona virus (SARS-Cov 2) is known to have neuro-ophthalmological manifestations such as optic neuritis, papillophlebitis, papilledema, visual disturbance associated with posterior reversible encephalopathy syndrome, and vision loss caused by stroke, Miller Fisher syndrome, Adie’s pupils, ocular myasthenia gravis, nystagmus eye movement disorders, and cranial neuropathies like third and sixth nerve palsies. Sixth nerve palsy in adults is mostly attributable to microvascular ischemia and trauma. Research suggests that SARS- COV 2 infection can result in inflammatory nerve damage due to aberrant immune response leading to neuropathy. We report a case of a 42-year-old man presenting with a unilateral abducens nerve palsy following Covid-19 infection treated with a course of steroids leading to faster recovery.

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

Cited by 3 publications

References 7 publications

Recurrent Isolated Sixth Nerve Palsy in Childhood—Review on a Rare Phenomenon

Recurrent Isolated Sixth Nerve Palsy in Childhood—Review on a Rare Phenomenon

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

Sixth nerve palsy post covid treated with course of oral steroids

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