AI Summary & Key Takeaways
AI InsightDiplopia decreased by the first month and his eye movements returned to normal by the 6th month after treatment. 6th cranial nerve palsy secondary to spinal anesthesia is a rare and temporary condition, which is thought to be secondary to the traction of 6th nerve due to intracranial hypotension following cerebrospinal fluid leakage.
📌 3 Key Takeaways
Abstract
A 52-year-old male patient presented with diplopia and strabismus, which developed 3 weeks ago following spinal anesthesia for inguinal hernia repair. He had left esotropia and abduction was limited (-4) in the left eye. The patient was diagnosed as having 6th cranial nerve palsy secondary to cerebrospinal fluid leakage following dural puncture and had intravenous hydration and epidural blood patch treatment. Diplopia decreased by the first month and his eye movements returned to normal by the 6th month after treatment. 6th cranial nerve palsy secondary to spinal anesthesia is a rare and temporary condition, which is thought to be secondary to the traction of 6th nerve due to intracranial hypotension following cerebrospinal fluid leakage.
Özet
Elli iki yaşında erkek hasta, 3 hafta önce inguinal herni cerrahisi için spinal anestezi aldıktan sonra başlayan sol gözde kayma ve çift görme yakınmalarıyla başvurdu. Sol gözde ezotropya ve abdüksüyonda -4 kısıtlılık mevcut olan hastada, spinal anestezi sonrasında beyin-omurilik sıvısı (BOS) kaçağına bağlı 6. kranial sinir felci tanısı düşünülerek sıvı replasman tedavisi ve epidural kan yaması uygulandı. Hastanın takibinde 1. ayda diplopinin azaldığı, 6. ayda ise göz hareketlerinin serbestleştiği görüldü. Spinal anestezi sonrası görülen nadir ve geçici bir durum olan 6. kranial sinir felcinin, BOS kaçağı sonucu oluşan intrakranial hipotansiyona sekonder 6. kranial sinirin traksiyona uğraması ile ortaya çıktığı düşünülmektedir. (Turk J Ophthalmol 2011; 41: 125-7)