Original Article

Survey of Paralytic Strabismus: A Regional Survay

Abstract

One of the important causes of strabismus in all ages is extraocular muscles paralysis due to 3rd, 4th and 6th cerebral nerve palsies. Exact and on-time treatment can result in improvement of deviation, am-blyopia and abnormal head posture. We studied epidemiological characteristics of extraocular muscles paralysis. This retrospective study performed on 131 subjects (58% male). Records of patients with diagnosis of paralytic strabismus referred to private clinics between 1995 and 2005 were studied and their demographic data and clinical characters were extracted and evaluated. Average age of patients was 23 years old. Unilateral involvement was seen in 94% of cases. The types of paralysis were 4th nerve (70.2%), 6th nerve (17.8%), 3rd nerve (12%) and all nerves palsy (3,4 Nerves) (2.2%). The most common causes of nerve injury were congenital (62.5%), trauma (19.8%), vascular (3.8%), iatrogenic (3%), tumor and aneurysm (2.2%) and miscellaneous (9%). The most common causes in 3rd nerve palsy were trauma (40%), congenital (20%), iatrogenic (10%), aneurysm (5%), vascular (5%) and miscellaneous (10%). Pupilary involvement was seen in 55% of cases and complete form of 3th nerve in 50% of patients. The most common causes in 4th nerve palsy were congenital (81.5%), traumatic (8.5%) and miscellaneous (10%). In 6th nerve palsy, the most common causes were trauma (50%), vascular (13.6%), congenital (9%). This study indicates that the most common type of palsy is 4th, 6th and 3rd nerves and the most common causes are congenital and trauma.

Miller NR, Newman NJ, Hoyt WF, Walsh FB, editors. Walsh and Hoyt's Clinical Neuro-ophthalmology. 5th ed. Baltimore, Md: Williams & Wilkins; 1998.

Von Noorden GK. Binocular vision and ocular motility: Theory and Management of Strabismus. 7th ed. St Louis: Mosby; 2004.

Rucker CW. Paralysis of the third, fourth and sixth cranial nerves. Am J Ophthalmol 1958; 46(6): 787-94.

Rucker CW. The causes of paralysis of the third, fourth and sixth cranial nerves. Am J Ophthalmol 1966; 61(5 Pt 2):1293-8.

Rush JA, Younge BR. Paralysis of cranial nerves III, IV,and VI. Cause and prognosis in 1,000 cases. Arch Ophthalmol1981; 99(1): 76-9.

Khawam E, Scott AB, Jampolsky A. Acquired superior oblique palsy. Diagnosis and management. Arch Ophthalmol1967; 77(6): 761-8.

Harley RD. Paralytic strabismus in children. Etiologic incidence and management of the third, fourth, and sixth nerve palsies. Ophthalmology 1980; 87(1): 24-43.

Reisner SH, Perlman M, Ben-Tovim N, Dubrawski C. Transient lateral rectus muscle paresis in the newborn infant. J Pediatr 1971; 78(3): 461-5.

Robertson DM, Hines JD, Rucker CW. Acquired sixthnerve paresis in children. Arch Ophthalmol 1970; 83(5): 574-9.

Bagery AB. Epidemyelogical survey of extra ocular palsy. J Bina Iranian Ophthal 1995; 5: 237-44. [Persian]

Maruo T, Iwashige H, Kubota N, Sakaue T, Ishida T, Honda M, et al. Results of surgery for paralytic exotropia due to oculomotor palsy. Ophthalmologica 1996; 210(3): 163-7.

Ellis FJ, Stein LA, Guyton DL. Masked bilateral superior oblique muscle paresis. A simple overcorrection phenomenon?Ophthalmology 1998; 105(3): 544-51.

Simons BD, Saunders TG, Siatkowski RM, Feuer WJ, Lavina AM, CapĆ³ H, et al. Outcome of surgical management of superior oblique palsy: a study of 123 cases. Binocul Vis Strabismus Q 1998; 13(4): 273-82.

Ariochane M, Repka M. Outcom of sixth nerve palsy or paresis in young children. J Pediatr Ophthalmol Strabismus 32(3): 152-6.

Files
IssueVol 47, No 3 (2009) QRcode
SectionOriginal Article(s)
Keywords
Strabismus oculomotor Muscles oculomotor nerve diseases

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Medghalchi A. Survey of Paralytic Strabismus: A Regional Survay. Acta Med Iran. 1;47(3):221-224.