Results of a prospective randomized trial of botulinum toxin therapy in acute unilateral sixth nerve palsy.
Forty-seven patients entered a prospective randomized trial to assess the effect of early botulinum neurotoxin A treatment to the ipsilateral antagonist medial rectus on the ultimate recovery rate of acute unilateral sixth nerve palsy. Twenty-two patients received injections and 25 acted as controls. The overall etiologies were microvascular (72.3%), unknown (17%), multiple sclerosis (6%), and one case each of central nervous system (CNS) sarcoidosis and basilar artery ectasia. Eighty-three percent of the patients entered the trial within 2 weeks of the onset of symptoms and 95.7% within 3 weeks. The controls had a final recovery rate of 20/25 (80%), and the injected group had a final recovery rate of 19/22 (86%). No serious side effects were encountered. We conclude that there is no evidence for a prophylactic effect of botulinum toxin in the group that we have studied.
Lee
J
J
Botulinum Toxin Clinic, Moorfields Eye Hospital, London, England.
Harris
S
S
Cohen
J
J
Cooper
K
K
MacEwen
C
C
Jones
S
S
D000010:Abducens Nerve; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001905:Botulinum Toxins / Q000627:therapeutic use*; D003389:Cranial Nerve Diseases / Q000188:drug therapy; D005133:Eye Movements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000188:drug therapy*; D011379:Prognosis; D011446:Prospective Studies; D015348:Vision, Binocular
D001905:Botulinum Toxins