A case of unilateral oculomotor nerve palsy after arachnoid cyst surgery in a Chinese boy

Abstract

The paper reports a successful case of unilateral oculomotor palsy treated with acupuncture in a Chinese boy aged 5 years and 3 months. Filiform needles were applied for ptosis, ocular motility impairment and blurred vision of the left oculomotor palsy after arachnoid cyst surgery. Two stages of treatment with acupuncture were composed. Acupuncture in the first stage focused on resolving stasis, unblocking meridians and activating qi and blood circulation, especially at the acupoints around the eye, combined with the distal points (four gate points) to enhance qi movement and activate blood circulation, once daily. Besides, the western medicines for nerve nutrition were added. One month later, all the symptoms were alleviated, and the eyelid could be lifted. Then, the second stage of acupuncture started, during which, the western medicine for nerve nutrition was withdrawal, acupuncture was continued with the same acupoints as the first stage, once every two days. Besides, the thumb-tack needle was used to maintain the effect of filiform needle, and Zusanli (ST36) was added to replenish qi of spleen and stomach and promote circulation of meridians. Another month later, the lift of the left eyelid and the ocular motility were basically symmetrical to the right eye, and the left eye vision returned normal. Follow-up until the time of publication, the motility and function of the affected eye were basically the same as those of the healthy side. This case suggests that the staged intervention with acupuncture could be effective in child with unilateral oculomotor palsy after arachnoid cyst surgery and were acceptable for child. Further studies are needed to confirm the effect and mechanism of acupuncture intervention on postoperative oculomotor palsy.