Lateral rectus muscle paralysis associated with closed-head trauma.
We examined 21 patients with closed-head trauma and resulting paralysis of the lateral rectus muscle. Clinical findings included laterally directed gaze palsy, some unconsciousness, and pseudo-duane's phenomenon suggesting a supranuclear lesion at the level of the upper pontine tegmentum, and pontine paramedial reticular formation. The surgical procedure of choice was a "midline operation," that is, the appropriate number of millimeters of recession and resection to achieve 0 to 5 degrees of exotropia in the primary position of gaze. Frequently, the medial rectus muscle must be recessed 10 nm or more and the lateral rectus muscle resected 10 nm or more to achieve this result. None of the 21 patients had diplopia after the midline procedure.
D000328:Adult; D002648:Child; D006259:Craniocerebral Trauma / Q000150:complications*; D004172:Diplopia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012018:Reflex; D013285:Strabismus / Q000175:diagnosis / Q000209:etiology / Q000601:surgery