Physiotherapy in postinfection injury to cranial nerves III, IV, and VI: a case study

The patient with bacterial infection sequelae in the form of damage to cranial nerves (CN) III, IV, and VI was followed-up. He had exhibited clinical and radiographic signs of paranasal sinusitis. Prior to his physiotherapy, the patient received standard treatment with natural and synthetic antibiotics and steroids. After acute signs of infection resolved without any functional improvement, the patient was referred to a rehabilitation unit to undergo neuromuscular re-education of the paralyzed extraocular muscles. Periorbital hydrocortisone iontophoresis and visuomotor exercises with intense ideomotor stimulation led to complete and rapid resolution of extraocular muscle paralysis and diplopia. Physiotherapy can be an effective treatment of choice after failed pharmacological treatment in patients with damage to CN III and VI. It has many theoretical advantages, including non-invasiveness and avoidance of first-pass metabolism of drugs administered systemically. Correspondence to: Agnieszka Olga Lewińska, MSc, 2nd Department of Clinical Radiology, Medical University of Warsaw, ul. Stefana Banacha 1a, 02-097 Warsaw, Poland, agnieszka.lewinska@wum.edu.pl, +48790013404 Declaration of Interest The Authors declare that there is no conflict of interest. Role of the funding source This study was not sponsored or funded. Details of any previous presentation of the research, manuscript, or abstract in any form None of our materials have been previously published or are otherwise copyrighted. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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