Hyperhomocysteinemia in Acquired Non-traumatic Paralytic Strabismus: A Case Series

• Main Authors: Priyanka Sharma, Urvish Vashist
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2020-04-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: abducens; oculomotor; serum homocysteine; trochlear nerve palsy
• Online Access: https://jcdr.net/articles/PDF/13662/44060_CE[Ra1]_F(SL)_PF1_(AG_KM)_PFA(KM)_PB(AG_KM)_PN(SL).pdf

Diabetes and hypertension are among the main causes of acquired non-traumatic paralytic strabismus in elderly. They cause ischemic changes in the cranial nerves resulting in paralysis. Recently, hyperhomocyteinemia has emerged as a risk factor in systemic ischemic diseases. Only a few studies have suggested role of homocysteine in acquired abducens palsy. This article describes six cases (2 males, 4 females) with hyperhomocysteinemia, out of 67 patients of acquired non-traumatic strabismus, seen over 10 years from January 2010 to December 2019. The mean age of patients was 45 years. Three patients had abducens palsy, while two patients had oculomotor palsy and one patient had trochlear nerve palsy. Two elderly females also had co-existing diabetes mellitus and dyslipidemia. It can be concluded that patients with acquired non-traumatic paralytic strabismus should be evaluated for serum homocysteine.