This retrospective cohort study aimed to report the incidence of ocular cranial nerve palsy as a result of traumatic brain injury (TBI). Patients were identified using an insurance database using codes from the International Classification of Disease 9th and 10th revisions. Inclusion criteria was diagnosis of ocular motor cranial nerve palsy diagnosed within three months of a TBI. Individuals with a greater than six-month gap of enrollment on the database and those with codes for diagnosis of an ocular motor cranial nerve palsy or strabismus surgery prior to the TBI were excluded. The following data was extracted: gender, age at diagnosis, time gap between TBI and ocular cranial nerve palsy diagnosis, time gap to strabismus surgery and severity of TBI. The incidence of ocular cranial nerve palsy was 0.071%, and a total of 1851 had a diagnosis of an ocular cranial nerve palsy of the 2,606,600 individuals who met the study inclusion criteria. Fourth cranial nerve palsies were the most common (37.7%). The incidence in children (0.026%) was lower than adults (0.111%). In children with TBI, sixth cranial nerve palsies were most common (44.7%). Third cranial nerve palsies were more prevalent in cases of moderate to severe TBI. The authors acknowledge limitations with this study including using claims data as the source which lacks clinical data including severity of ocular motility, measurement of strabismus and cyclotorsion, pupillary involvement, visual acuity and factors involved in TBI severity classification. Individuals aged over 65 years of age were excluded from this study due to the inclusion criteria of the claims database. This study highlights the differences in presentation between adults and children with ocular cranial nerve palsy following TBI. Further studies are required to expand the population to include older adults.
How common are ocular motor cranial nerve palsies following TBI?
Reviewed by Lauren Hepworth
Ocular motor nerve palsy after traumatic brain injury: a claims database study.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
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