OJOph  Vol.2 No.1 , February 2012
Usefulness of Botulinum Toxin Type-A in the Treatment of Chronic Sixth Nerve Palsy
ABSTRACT
Purpose: The purpose of the study was to evaluate the efficacy of botulinum toxin type A (BTX-A) injection in patients with acquired VI nerve palsy. Methods: Twenty-eight patients (16 F and 12 M), mean age 36.4 +/-- 17.8 DS; range 10 - 69 years with acquired VI nerve palsy, have been treated with BTX-A injection into the ipsilateral medial rectus, at least 6 months after onset. At 6 months follow up, a paresis and a paralysis, were respectively diagnosed if the affected eye could be actively abducted or not, across the mid-line; a simple horizontal rectus muscle procedure was performed for the paresis whilst for the paralysis, both a horizontal and vertical muscle transportation procedure were required. Results: A gradual physiological recovery of the lateral rectus muscle was observed in 9 (32%) patients (GROUP I) and surgical treatment was therefore unnecessary; the remaining 19 cases (68%), of which 5 paresis (GROUP II) and 14 paralysis (GROUP III) underwent surgery and within 1 year were all restored to orthotropia. Conclusion: Botulinum toxin type-A (BTX-A) injection is an invaluable tool in the differential diagnosis between paresis versus paralysis of the VIth nerve, allowing the correct choice of surgical procedure.

Cite this paper
L. Sabetti, I. Greco, D. Lodovico and A. Berarducci, "Usefulness of Botulinum Toxin Type-A in the Treatment of Chronic Sixth Nerve Palsy," Open Journal of Ophthalmology, Vol. 2 No. 1, 2012, pp. 1-4. doi: 10.4236/ojoph.2012.21001.
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