• The Journal of Internal Korean Medicine
• /
• v.40 no.3
• /
• pp.409-424
• /
• 2019

Objectives: This research aimed to confirm the efficacy of oriental medicine in sixth cranial nerve palsy and to evaluate the quality of the studies. Methods: Using the medical subject heading (MeSH) keywords "abducens nerve palsy", "abducens nerve paralysis", "sixth nerve palsy", "herbal medicine", "Chinese medicine", "oriental medicine" and "acupuncture", we collected the research papers through an electronic database search in Oriental Medicine Advanced Searching Integrated System (OASIS), National Discovery for Science Leaders (NDSL), PubMed, Cochran Library, and China National Knowledge Infrastructure (CNKI). Results: A total of 136 papers were searched from the databases. Among these, 15 case reports and 8 randomized controlled trials (RCTs) met our criteria. 17 articles were found on the use of acupuncture as the main intervention, 11 on the use of herbal medicine as the main intervention, and 9 on the use of electroacupuncture as the main intervention. The frequently used acupoints were LI4, EX-HN5, GB1, BL2, TE23, LR3, BL1, ST2, GB20, and ST36. All 23 studies confirmed the efficacy of Korean medicine. According to the assessment using the risk of bias, the overall quality of the RCTs was low. Conclusions: Twenty-three papers suggested that Korean medicine treatment for abducens nerve palsy was effective in many cases. Analyzing the potential bias was difficult.

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.15 no.1
• /
• pp.57-65
• /
• 2014

■ Objectives The purpose of this case report is to show an effect of korean medicine for patient with bilateral abducens nerve palsy. ■ Methods This patient was 58 year-old man who was diagnosed with bilateral abducens nerve palsy. The patient had Diabetes Mellitus, hypertension, benign prostatic hyperplasia and dyslipidemia as underlying diseases. The patient had symptoms of limited eye movement to lateral, diplopia, dizziness and mild headache. He was treated by korean medicine, containing electroacupuncture, pharmacoacupuncture, moxibustion and herb medicines during 13 days of hospitalization and following outpatient department. His eye movement was evaluated by the method of Scott and kraft and discomfort from his symptoms was scored by the Numerous Rating Scale. And other general conditions were measured. ■ Results After that period, patient's abduction deficit was improved and subjective discomfort from his symptoms was getting better. His other conditions were also better, compared with his admission. ■ Conclusion This study suggests that Korean medicine could have a therapeutic effect for bilateral abducens nerve palsy. So, It could help to relieve patient's symptoms and make general conditions better.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.29 no.2
• /
• pp.123-129
• /
• 2016

Objectives : The aim of this report was to evaluate the effects of Traditional Korean Medicine (TKM) in a patient suffering from abducens palsy. Methods : Acupuncture was applied to Left Sojangjungkyuk(BL66, SI2, GB41, SI3) for 15 minutes in all visits. Herbal medicine (Banggihwanggi-Tang) was administered regularly three times a day after each meal. Results : Patient's main symptoms remarkably improved after treatment. Conclusions : TKM therapy may be helpful in the treatment of ocular abnormalities related to abducens palsy.

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.18 no.1
• /
• pp.67-75
• /
• 2017

■ Objective This is a case report about monocular abducens nerve palsy in a patient with pontine infarction. ■ Method At the time of onset, the patient had eye movement impairment in right eye and diplopia. Brain MRI image showed that there was an infarction in the right pons where the nucleus of abducens nerve is located. There was no obvious improvement in the eye movement before he received Korean medicine treatment. He recieved Korean medicine including acupuncture, electroacupuncture, pharmacoacupuncture and herb medicines for fifty three days. ■ Result After treatment, the movement of right eye was improved to a normal range. The difference in distance from 'center of the pupil' to 'external canthus of the eye' at maximum abducent in both eye changed 0.9cm to 0.1cm at the discharge. In addition, Diplopia was improved at the discharge. ■ Conclusion This case report demonstrated that the Korean medicine treatment is effective to diplopia and eye movement impairment from abducens nerve palsy caused by pontine infarction.

• The Journal of Internal Korean Medicine
• /
• v.33 no.4
• /
• pp.599-608
• /
• 2012

Objectives : To report three cases of eye movement impairment: internuclear ophthalmoplegia (INO) due to pontine infarction, traumatic abducens nerve palsy, and abducens nerve involvement in Miller-Fisher syndrome. Cases Summary : There were three cases. First, a 64-year-old woman, who was given a diagnosis of INO due to pontine infarction, had left gaze palsy of her right eye while the convergence was intact. Second, a 34-year-old man had abduction impairment of his right eye after a traffic accident. Third, a 66-year-old man, who was diagnosed with Miller-Fisher syndrome, had left gaze palsy of his left eye. Their symptoms improved substantially and their anxieties were relieved after treatment with herbal medicine and acupuncture. Conclusions : There has been no certain cure for eye movement impairment yet. In this report, we present three successful cases of patients with eye movement impairment and show that Korean medical treatment could be a solution for this incurable disease.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.4
• /
• pp.288-292
• /
• 2012

Objective : Microvascular decompression (MVD) for hemifacial spasm (HFS) is a safe and effective treatment with favorable outcomes. The purpose of this study was to evaluate the incidence of delayed cranirve (VI, VII, and VIII) palsy following MVD and its clinical courses. Methods : Between January 1998 and December 2009, 1354 patients underwent MVD for HFS at our institution. Of them, 100 patients (7.4%) experienced delayed facial palsy (DFP), one developed sixth nerve palsy, and one patient had delayed hearing loss. Results : DFP occurred between postoperative day number 2 and 23 (average 11 days). Ninety-two patients (92%) completely recovered; however, House-Brackmann grade II facial weakness remained in eight other patients (8%). The time to recovery averaged 64 days (range, 16 days to 9 months). Delayed isolated sixth nerve palsy recovered spontaneously without any medical or surgical treatment after 8 weeks, while delayed hearing loss did not improve. Conclusion : Delayed cranial nerve (VI, VII, and VIII) palsies can occur following uncomplicated MVD for HFS. DFP is not an unusual complication after MVD, and prognosis is fairly good. Delayed sixth nerve palsy and delayed hearing loss are extremely rare complications after MVD for HFS. We should consider the possibility of development of these complications during the follow up for MVD.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.10
• /
• pp.1345-1351
• /
• 2000

Objective : Around the sellar area, there are many important structures. But, the optimal radiation dosage for minimal toxicity to surrounding neural tissue has not been firmly established. The purpose of this study is to evaluate the radiosurgical outcome of juxtasellar tumors and to investigate the relationship between radiation dosage and toxicity to neural tissue. Method : Between May 1992 and June 2000, we treated 65 juxtasellar tumors by using the Leksell Gamma Knife. Among them, 52 patients who could be followed more than 1 year were included in this study. The radiosurgical dosage to the optic pathway, cavernous sinus, Meckel's cave, hypothalamus, pituitary gland and stalk, and brain stem was analyzed and correlated with clinical outcome. The mean follow-up period was 33.5 months(range 12.2- 99.0 months). Result : The clinical response rate was 69.2%. The volume response rate was 61.0% and the radiologic control rate was 92.7%. There were 4 complications(7.7%) of 2 trigeminal neuropathy, 1 abducens nerve palsy, and 1 trigeminal and transient abducens nerve palsy. The optic apparatus appeared to tolerate doses greater than 10Gy. The risk of cranial nerve complications in cavernous sinus seemed to be related to doses of more than 16Gy. In 3 of 4 patients who received more than 16Gy to cavernous sinus, the abducens or trigeminal neuropathy occurred. Also, one patient who received more than 15Gy to the Meckel's cave, trigeminal neuropathy developed. The hypothalamus, pituitary gland and stalk, and brain stem were relatively tolerable to radiation. Conclusion : Gamma Knife radiosurgery seems to be an effective method to control the growth of juxtasellar tumors. To avoid injury to surrounding important neural tissue, careful dose planning and further study for radiation toxicity to neural tissue were needed.

• Journal of Convergence Korean Medicine
• /
• v.1 no.1
• /
• pp.5-15
• /
• 2021

Objectives: To review the concept of Moebius syndrome. Methods: Literature search was done to study definition, epidemiology, pathophysiology, clinical feature, and treatment of Moebius syndrome. Pubmed, RISS, Google scholarship and uptodate scholastic were used in the research. Search words were 'Moebius syndrome', 'treatment of Moebius syndrome'. Only English and Korean studies were assessed. Results: Moebius syndrome is rare disease characterized by nonprogressive congenital uni- or bi-lateral facial (VII cranial nerve) and abducens (VI cranial nerve) palsy. This facial palsy is found across the world, and its incidence is approximately 1 per 250,000. Moebius is diagnosed by clinical features. Facial palsy, eye abduction problem, limb deformities, global cerebral nerve impairment can be shown. Rehabilitation, smile surgery, and acupuncture can be used to treat this. Conclusion: Moebius syndrome's epidemiology, pathogenesis, treatment is still not fully revealed. It is known to be a congenital disease which didn't have exact treatment except surgery. But, it needs further study about exact treatment, diagnosis, and pathogenesis.

• Journal of Yeungnam Medical Science
• /
• v.38 no.2
• /
• pp.152-156
• /
• 2021

Diplopia is a rare complication of spine surgery. The abducens nerve is one of the cranial nerves most commonly related to diplopia caused by traction injury. We report a case of a 71-year-old woman who presented with diplopia developing from abducens nerve palsy after C1-C2 fixation and fusion due to atlantoaxial subluxation with cord compression. As soon as we discovered the symptoms, we suspected excessive traction by the instrument and subsequently performed reoperation. Subsequently, the patient's symptoms improved. In other reported cases we reviewed, most were transient. However, we thought that our rapid response also helped the patient's fast recovery in this case. The mechanisms by which postoperative diplopia develops vary and, thus, remain unclear. We should pay attention to the fact that the condition is sometimes an indicator of an underlying, life-threatening condition. Therefore, all patients with postoperative diplopia should undergo thorough ophthalmological and neurological evaluations as well as careful observation by a multidisciplinary team.