Dorothy FarrarAbductive palsy
Abducens palsy is paralysis of the sixth cranial nerve. It can occur on one or both sides and the eyes are always affected. The main symptoms are squinting and seeing double vision. The disease occurs in both infants and the elderly, and there is no evidence of an increase in numbers with age.
What is Abducens Palsy?
The technical term abducens paresis is made up of two words, abduzens and paresis. Both have their origin in Latin. Abucere means to move or lead outward. Paresis is the general term for paralysis. Abduzens nerve and lateral rectus muscle (lateral rectus muscle) are two parts of the brain whose job is to turn your eyes sideways.
The sixth cranial nerve innervates the muscle here and that means that it gives it the necessary stimuli to move the eyeball. The abduzens nerve is one of the motor nerves. If this nerve is pinched or damaged by pressure, infectious disease , or trauma , ocular muscle paralysis results. Symptoms of paralysis of the inner and outer eye muscles are also commonly referred to as ophthalmoplegia.
Causes
Aneurysms are bulges in arteries and they occur in areas such as the brain. They are bulky and by increasing their volume they press on the VI. cranial nerve. The result of the pressure is that it no longer adequately innervates the lateral muscle of the eye. Nerve inflammation at the base of the skull can also be the reason for abductive nerve palsy. Thrombosis, hemorrhoids and fistulas in the venous system form blood clots which, as soon as they press on the cranial nerve, lead to paresis. One of the triggers for an infectious disease is syphilis.
If the course of the disease is latent, i.e. unnoticed, circulatory disorders in the brain occur. This leads to neurological disorders, which include abducens palsy. Sarcoidosis is a disease that primarily affects the lungs and lymph nodes. Tiny granulomas are formed that reach the base of the skull through the lymphatic system. There they cause the function of the VI. cranial nerve is interrupted. Increased intracranial pressure, which is caused by injuries, tumors and Korsakoff’s syndrome (amnesia due to alcohol abuse), among other things, leads in many cases to abducens palsy.
Symptoms and course
Typical symptoms of abducens palsy:
Sudden squinting of one or both eyes is one of the first symptoms. The “inward squinting” is significant. This means that the eyes are directed extremely towards the nose. At the same time, those affected report diplopia, double vision. If you keep an eye out, it will capture individual images again. Double vision occurs more often when looking into the distance. To stop the symptom, patients adopt a forced posture. You then turn your head to the affected side and compulsively stay in that position. The course of this paralysis depends on the cause. If it is a short-term circulatory disorder, the symptoms subside by themselves after a few days or weeks. If the cause is not diagnosed very early and the paralysis persists, an operation is often unavoidable.
Diagnosis
The ophthalmologist can already determine from anamnesis and the clinical picture that an abduzen paresis is present. Then the cause must always be determined. Brain tomography scans or magnetic resonance imaging (MRI) scans of the skull provide a clear picture of the cause of the paralysis. Sometimes PET (positron emission tomography) is also used. By administering a contrast medium, the activity of the brain can be observed precisely. All measures are part of the imaging procedures when examining the brain. In older patients, paralysis of the abductor can indicate diabetes. Here the diagnosis should be made with the help of internists. Ask the medical specialists a diabetes, further investigations are superfluous. In most cases, the paralysis resolves on its own once the underlying disease is treated.
Complications
In the case of paralysis of the abductor, the patient usually suffers from discomfort in the eyes. A strong squint occurs and the view is mostly disturbed by double vision. These complaints limit the patient’s everyday life and can also lead to psychological problems. The double vision often leads to strong feelings of dizziness and, therefore, not infrequently to vomiting . An unhealthy head position is often adopted in the case of abduzen paresis in order to counteract the symptoms. It can damage muscles and nerves in the back and neck, which can lead to complications in those areas.
The quality of life decreases significantly due to the paralysis of the abductor. If the nerves in the brain are compressed over a long period of time, this can also result in irreversible damage. In most cases, a surgical intervention is possible, which removes and completely combats the symptoms of the abductive palsy. If the squint does not go away on its own, a second operation can be performed. The muscle can be treated again during muscle transposition, allowing the person to move their eyes normally again. If the treatment is successful, there are no further complications or complaints.
Treatment and therapy
The first step in treating abductive nerve palsy must always be to address the cause. If the trigger is an inflammation, medication must be administered until it heals. Space-occupying changes in the brain may need to be surgically removed. This can be a tumor or a blood clot . The earlier this happens, the better the chance of a complete cure. The nerve will only work again without restriction if the pressure has not lasted for months.
Ophthalmologists can start an immediate treatment of double vision with a prism sheet. This means that there are no more double images when looking straight ahead. Other immediate measures include wearing an eye patch or masking a lens with a matt film. These measures are often performed on children. Squinting in infants and young children must be examined in good time. The presentation to a specialist is so important because the brain is not able to learn to see normally without therapy.
A congenital nerve palsy that is diagnosed and treated early usually heals completely. Therapy started too late leads to permanent loss of healthy vision. If the paralysis does not resolve even after a year, surgery may be necessary. It can be performed under local or general anesthesia. The aim of the measure is that by correcting the eye muscle, double vision and squinting are completely prevented or reduced to a minimum. The methods are different. Excessive traction of the lateral rectus muscle can be alleviated by resection. This involves removing part of the muscle. Also, shifting or folding the muscle causes its pull to normalize.
Prevention
There are no prophylactic, active measures. Early diagnosis and treatment of the diseases considered to be the cause can reduce the risk of abducens palsy. It is important that the administration of blood coagulants is started early after a craniocerebral trauma . Babies who often squint or toddlers who express double vision need to be seen by a specialist.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.