Abnormal Head Posture in Patients with Third and Sixth Cranial Nerve Palsy
Steven M. Archer, M.D.
Patients with sixth nerve paresis, third nerve paresis or isolated cyclovertical muscle paresis frequently develop characteristic head postures. These head postures serve to avoid diplopia or, when fixation is with the paretic eye, to allow fixation of a target directly in front of the patient.
Temporary management of the abnormal head posture can be accomplished by patching one eye, with a Fresnel prism or with Botulinum toxin. When spontaneous resolution of he paresis does not occur, surgical treatment is usually needed for permanent correction of the face turn. Surgical outcomes are usually satisfactory except in cases of complete or nearly complete third nerve palsy.
© 1996 The Board of Regents of the University of Wisconsin System