Botulinum toxin in acute sixth nerve palsy

Abstract

Purpose: To investigate the effect of botulinum toxin therapy in acute sixth nerve palsy. Methods: 22 patients were enrolled in the study; 14 were in the toxin group and 8 were in the control group. Patients in the toxin group received botulinum toxin injections of 2.5 to 5 IU into the ipsilateral antagonist of tfee paralyzed muscle. Follow up was sixth months with intervening visits at first week, first and fourth month. Absence of diplopia and esotropia of < 10 prism diopters at primary position was defined as recovery. P< 0.05 was needed for statistical significance. Results: At the end of six months, recovery rate was 85.7% in the toxin group and 87.5% in the control group; difference was not statistically significant (p=0.907). Significant improvement in esotropia, abduction deficiency and consequently diplopia was seen at the end of the first month in the toxin group. In the control group significant improvement was not observed until the end of the fourth month. Conclusion: In acute sixth nerve palsy, botulinum toxin therapy can provide faster recovery and early symptomatic relief.

Özet

Amaç: Akut 6. sinir paralizili hastalarda botulinum toksin uygulanımının iyileşme sürecine ve oranına etkisi araştırmak. Gereç ve Yöntem: Çalışmaya 22 hasta dahil edildi. 14 hasta toksin grubunda, 8 hasta kontrol grubunda yer aldı. Toksin grubuna dahil edilen hastalarda, paralitik kasın ipsilateral antagonist kası içine 2,5-5 IU botulinum toksin enjeksiyonu uygulandı. Birinci hafta, birinci, dördüncü ve altıncı ayda kontrol muayenelei yapıldı. Primer pozisyonda 10 prism dioptri veya daha az kayma olması ve çift görme olmaması iyileşme olarak kabul edildi. Sonuçlar, anlamlılık p