| Clinical Course and Characteristics of Acute Presentation of Fourth Nerve Paresis. | |
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MedLine Citation:
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PMID: 22800797 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE:Many cases of acute-onset cranial nerve paresis have benign etiologies such as microvascular occlusion. Most will resolve completely and neuroimaging is usually unnecessary. Few reports exist on acute fourth nerve paresis. METHODS:A retrospective review was conducted of all patients presenting with diplopia to the emergency department for 1 year caused by isolated fourth cranial nerve paresis from any cause including trauma. RESULTS:Thirty-two patients met the criteria, 26 (81%) males and 6 (19%) females, with an average age of 59.5 years (range: 14 to 80 years). Eighteen (56%) had a microvascular etiology with diabetes mellitus, hypertension, or both; 6 were already taking medication. Six (19%) had decompensating fourth nerve paresis (2 had hypertension and 1 had recent head trauma). Closed head trauma accounted for 2 patients, migraine and herpes zoster virus accounted for one each, and 4 remained unknown. Nineteen patients (59%) were prescribed prisms and 2 patients were given occlusion. Diplopia resolved without treatment in 23 patients (72%) within 2 weeks to 10 months, but 89% of patients with microvascular etiology resolved spontaneously. Three patients continued with prisms, one patient underwent surgery. CONCLUSION:The prognosis for complete and spontaneous resolution of microvascular fourth nerve paresis was excellent, with 89% completely resolved within 10 months. |
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Authors:
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Ayman Khaier; Emma Dawson; John Lee |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-17 |
Journal Detail:
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Title: Journal of pediatric ophthalmology and strabismus Volume: - ISSN: 1938-2405 ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7901143 Medline TA: J Pediatr Ophthalmol Strabismus Country: - |
Other Details:
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Languages: ENG Pagination: 1-4 Citation Subset: - |
Copyright Information:
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Copyright 2012, SLACK Incorporated. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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