Dose response of Botulinum toxin without electromyographic assistance for sixth nerve palsy

Dr.Manish Sharma ,Dr. Vikas Tyagi, , Dr. Suma Ganesh, Dr. Varshini Shanker, Dr. Priyanka

Purpose: To evaluate the effect, complications and dose response of botulinum toxin A injection in the treatment of sixth nerve palsy without electromyographic (EMG) assistance

Methods: Retrospective interventional case series of 13 patients who underwent injection Botulinum toxin without EMG assistance within 3 months of onset of sixth nerve palsy.
Results: Complete resolution was seen in 8 patients. No serious complication noted. 5u of toxin effectively reduced up to 30 prism dioptre of deviation but was not effective for abduction deficit of -4.

Conclusions: Botulinum toxin in the dose of 5units can be safely and effectively used for treatment of acute sixth nerve palsy without electromyographic assistance in small to moderate deviations up to 30 prism dioptres.