Temporary management of diplopia with botulinum toxin in multiple ocular motor cranial neuropathies.

Abstract:

PURPOSE:To report management of diplopia with botulinum toxin injection in traumatic multiple ocular motor cranial neuropathies. 
 METHODS:Alternate prism and cover measurement of deviation in different positions of gaze, examination of ductions, field of binocular single vision, and complete ocular anterior and posterior segment evaluation were carried out. CT and MRI of the orbit were available. 
 RESULTS:We describe a case of traumatic VI, IV, and mainly superior III cranial nerve palsies, with left hypotropia of 35 prism diopters and esotropia of 45 prism diopters and incapacitating diplopia, due to fracture of the roof and lateral wall of the orbit, extending to the superior orbital fissure, as demonstrated by CT and MRI of the orbit. Severe limitation of abduction, elevation, and depression of the left eye was found. A single botulinum toxin injection in the medial rectus with diffusion to the inferior rectus was effective as a temporary measure for the treatment of diplopia and attainment of a small field of binocular single vision. The patient remained symptom-free for 5 months after injection.
 CONCLUSIONS:Botulinum toxin injection may be useful for the temporary management of diplopia in multiple ocular motor cranial neuropathies.

journal_name

Eur J Ophthalmol

authors

Tejedor J,Díez L

doi

10.5301/ejo.5000202

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

1042-4

issue

6

eissn

1120-6721

issn

1724-6016

pii

7F1E39B5-2AD8-4F87-966F-A8152F6FB725

journal_volume

22

pub_type

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