RESUMO
CASE REPORT: To describe a case of combined bilateral cranial nerve palsy of traumatic origin. To determine the lesions that produce the symptoms is useful to define the final prognosis and the best treatment. DISCUSSION: We report the case of a patient who developed a bilateral sixth nerve and left third nerve palsy after head trauma. The underlying lesion was a diffuse axonal injury. After an observation period during which no spontaneous improvement occurred, we administered botulinum toxin with a successful clinical result. Bilateral combined traumatic cranial nerve palsies are rare. When a diffuse axonal injury is present, the chance of spontaneous resolution is poor.
Assuntos
Doenças do Nervo Abducente/etiologia , Traumatismos Craniocerebrais/complicações , Doenças do Nervo Oculomotor/etiologia , Doenças do Nervo Abducente/diagnóstico , Doenças do Nervo Abducente/tratamento farmacológico , Idoso , Toxinas Botulínicas Tipo A/uso terapêutico , Humanos , Imageamento por Ressonância Magnética , Masculino , Fármacos Neuromusculares/uso terapêutico , Doenças do Nervo Oculomotor/diagnóstico , Doenças do Nervo Oculomotor/tratamento farmacológico , Resultado do TratamentoRESUMO
Caso clínico: Describir un caso de parálisis bilateral combinada de origen traumático. Conocer las lesiones que ocasionan la clínica nos es útil para inferir el pronóstico final y tratamiento más adecuado.Discusión: Presentamos un paciente con una parálisis del III par izquierdo y VI par bilateral de origen traumático. El daño anatomofuncional era una lesión axonal difusa. Tras un período de observación sin presentar mejoría se realizó una inyección de toxina botulínica con la que mejoró clínicamente. Las lesiones de pares craneales combinadas y bilaterales traumáticas son infrecuentes. Si son por un daño axonal difuso las expectativas empeoran
Case report: To describe a case of combined bilateral cranial nerve palsy of traumatic origin. To determine the lesions that produce the symptoms is useful to define the final prognosis and the best treatment.Discussion: We report the case of a patient who developed a bilateral sixth nerve and left third nerve palsy after head trauma. The underlying lesion was a diffuse axonal injury. After an observation period during which no spontaneous improvement occurred, we administered botulinum toxin with a successful clinical result. Bilateral combined traumatic cranial nerve palsies are rare. When a diffuse axonal injury is present, the chance of spontaneous resolution is poor
