Clinical control study of acute idiopathic abducens nerve palsy treated with injections of dexamethasone into the lateral rectus muscle

Abstract

Abstract PURPOSE: To explore the efficacy and safety of local injections of dexamethasone into the lateral rectus muscle for treatment of acute idiopathic abducens nerve palsy (AIANP). METHODS: A study group and a control group were established for this study. The former received dexamethasone injections into the paralyzed lateral rectus muscle in combination with oral mecobalamin tablets. The control group only received mecobalamin tablets for no more than two months. The follow-up period was > 6 months. Incidence of lateral rectus palsy and diplopia were recorded, as well as complications. RESULTS: Between September 2019 and September 2022, a total of 72 patients with AIANP were included in this study (mean age: 54.1 ± 15.8 y). After treatment, all 39 patients in the study group were successfully treated (100%), while only 27/33 (81.8%) patients in the control group were successfully treated. This difference between groups was statistically significant (Fisher’s exact test, P = 0.01). Recovery times for the two groups also differed (3.45 ± 1.49 weeks vs. 12.1 ± 9.83 weeks, respectively; P < 0.001). Among the two groups, only one case of conjunctival congestion was reported at the injection site in the treatment group. Furthermore, recurrence was not observed during the follow-up period (17.9 ± 8.17 months). CONCLUSION: Dexamethasone injections into the lateral rectus muscle of AIANP patients are found to be a safe and effective treatment. They also improved the treatment rate and shortened treatment time．