{"title":"COVID-19感染引起的孤立外展神经麻痹:临床特征和结局","authors":"You-Jiang Tan, Shawn Zhen-Ji Lin","doi":"10.4103/neurol-india.Neurol-India-D-24-00411","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Isolated abducens nerve palsies from COVID-19 infections are rarely described in literature. Their clinical features are poorly understood, and guidance on their treatment is lacking.</p><p><strong>Objective: </strong>To describe the clinical features of isolated abducens nerve palsies from COVID-19 infection, and provide guidance on their management.</p><p><strong>Methods: </strong>We performed a literature review and analyzed the clinical features of patients with isolated abducens nerve palsy from COVID-19 infections reported in literature.</p><p><strong>Results: </strong>In total, 16 cases from 15 studies published between January 2020 and December 2023 were identified. Their median age was 44 years (range 3-71, including two children). Nearly two-thirds (10/16, 63%) were without medical history. Abducens nerve palsies mostly occurred early with COVID-19 symptoms (median of 5.5 days, range 0-21 days). They were all unilateral, and displayed neither clear gender nor left-right predilections. Brain magnetic resonance imaging scans were often unremarkable (9/13, 69%). More than half (9/16, 56%) received no treatment or symptomatic treatment only, while only two received steroids. Regardless, nearly all experienced clinical of diplopia (14/16, 88%), of which most recovery were either complete or near-complete (at least 10/14, 71%) within a median period of 26 days (range 5-240 days).</p><p><strong>Conclusion: </strong>Isolated abducens nerve palsies are early but uncommon complications of COVID-19, mainly affecting patients with mild infections. Prognosis appears fair even when without corticosteroid treatment, and recovery is significant and early in most. Observation and early outpatient clinical review within a month are reasonable measures. Patients without significant improvement within a month should be re-assessed for other aetiologies.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 3","pages":"524-528"},"PeriodicalIF":0.9000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Isolated Abducens Nerve Palsies from COVID-19 Infections: Clinical Features and Outcomes.\",\"authors\":\"You-Jiang Tan, Shawn Zhen-Ji Lin\",\"doi\":\"10.4103/neurol-india.Neurol-India-D-24-00411\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Isolated abducens nerve palsies from COVID-19 infections are rarely described in literature. Their clinical features are poorly understood, and guidance on their treatment is lacking.</p><p><strong>Objective: </strong>To describe the clinical features of isolated abducens nerve palsies from COVID-19 infection, and provide guidance on their management.</p><p><strong>Methods: </strong>We performed a literature review and analyzed the clinical features of patients with isolated abducens nerve palsy from COVID-19 infections reported in literature.</p><p><strong>Results: </strong>In total, 16 cases from 15 studies published between January 2020 and December 2023 were identified. Their median age was 44 years (range 3-71, including two children). Nearly two-thirds (10/16, 63%) were without medical history. Abducens nerve palsies mostly occurred early with COVID-19 symptoms (median of 5.5 days, range 0-21 days). They were all unilateral, and displayed neither clear gender nor left-right predilections. Brain magnetic resonance imaging scans were often unremarkable (9/13, 69%). More than half (9/16, 56%) received no treatment or symptomatic treatment only, while only two received steroids. Regardless, nearly all experienced clinical of diplopia (14/16, 88%), of which most recovery were either complete or near-complete (at least 10/14, 71%) within a median period of 26 days (range 5-240 days).</p><p><strong>Conclusion: </strong>Isolated abducens nerve palsies are early but uncommon complications of COVID-19, mainly affecting patients with mild infections. Prognosis appears fair even when without corticosteroid treatment, and recovery is significant and early in most. Observation and early outpatient clinical review within a month are reasonable measures. Patients without significant improvement within a month should be re-assessed for other aetiologies.</p>\",\"PeriodicalId\":19429,\"journal\":{\"name\":\"Neurology India\",\"volume\":\"73 3\",\"pages\":\"524-528\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurology India\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4103/neurol-india.Neurol-India-D-24-00411\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurology India","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/neurol-india.Neurol-India-D-24-00411","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/23 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Isolated Abducens Nerve Palsies from COVID-19 Infections: Clinical Features and Outcomes.
Background: Isolated abducens nerve palsies from COVID-19 infections are rarely described in literature. Their clinical features are poorly understood, and guidance on their treatment is lacking.
Objective: To describe the clinical features of isolated abducens nerve palsies from COVID-19 infection, and provide guidance on their management.
Methods: We performed a literature review and analyzed the clinical features of patients with isolated abducens nerve palsy from COVID-19 infections reported in literature.
Results: In total, 16 cases from 15 studies published between January 2020 and December 2023 were identified. Their median age was 44 years (range 3-71, including two children). Nearly two-thirds (10/16, 63%) were without medical history. Abducens nerve palsies mostly occurred early with COVID-19 symptoms (median of 5.5 days, range 0-21 days). They were all unilateral, and displayed neither clear gender nor left-right predilections. Brain magnetic resonance imaging scans were often unremarkable (9/13, 69%). More than half (9/16, 56%) received no treatment or symptomatic treatment only, while only two received steroids. Regardless, nearly all experienced clinical of diplopia (14/16, 88%), of which most recovery were either complete or near-complete (at least 10/14, 71%) within a median period of 26 days (range 5-240 days).
Conclusion: Isolated abducens nerve palsies are early but uncommon complications of COVID-19, mainly affecting patients with mild infections. Prognosis appears fair even when without corticosteroid treatment, and recovery is significant and early in most. Observation and early outpatient clinical review within a month are reasonable measures. Patients without significant improvement within a month should be re-assessed for other aetiologies.
期刊介绍:
Neurology India (ISSN 0028-3886) is Bi-monthly publication of Neurological Society of India. Neurology India, the show window of the progress of Neurological Sciences in India, has successfully completed 50 years of publication in the year 2002. ‘Neurology India’, along with the Neurological Society of India, has grown stronger with the passing of every year. The full articles of the journal are now available on internet with more than 20000 visitors in a month and the journal is indexed in MEDLINE and Index Medicus, Current Contents, Neuroscience Citation Index and EMBASE in addition to 10 other indexing avenues.
This specialty journal reaches to about 2000 neurologists, neurosurgeons, neuro-psychiatrists, and others working in the fields of neurology.