Huang Yi, Hu Hantong, He Kelin, Li Xinyun, Chen Qinqin, Ma Ruijie
Key Laboratory of Acupuncture and Neurology of Zhejiang Province, The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, China.
Key Laboratory of Acupuncture and Neurology of Zhejiang Province, The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, China; Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, China.
Explore (NY). 2023 May-Jun;19(3):469-474. doi: 10.1016/j.explore.2022.06.005. Epub 2022 Jun 11.
Delayed abducens nerve palsy after chemoradiotherapy for nasopharyngeal carcinoma (NPC) is often accompanied by ocular ischemia and cranial nerve damage, thereby increasing the risk of conventional strabismus surgery. Therefore, patients often prefer conservative treatment. Herein we report a case of acupuncture for delayed abducens nerve palsy after chemoradiotherapy for NPC.
A 39-year-old patient who previously received chemotherapy and radiotherapy for NPC developed a unilateral abducens nerve palsy with numbness in the face and stiffness in the neck muscles after six years. Based on magnetic resonance imaging (MRI), medical history, and physical examination, he was diagnosed with abducens nerve palsy after chemoradiotherapy. The acupuncture treatment regimen was mainly based on periocular electroacupuncture, supplemented with wheat grain moxibustion and warming needle moxibustion, which were performed three times a week. After one month with a total of 17 acupuncture sessions, the patient's affected eye abduction function recovered completely. Facial sensory abnormalities and neck stiffness also improved significantly. Follow-up at two months reported no recurrence.
Acupuncture may be a conservative treatment option for patients with abducens nerve palsy after chemoradiotherapy.
鼻咽癌（NPC）放化疗后迟发性外展神经麻痹常伴有眼部缺血和脑神经损伤，从而增加了传统斜视手术的风险。因此，患者通常倾向于保守治疗。在此，我们报告一例鼻咽癌放化疗后迟发性外展神经麻痹的针灸治疗病例。
一名39岁的患者曾接受过鼻咽癌的化疗和放疗，六年后出现单侧外展神经麻痹，伴有面部麻木和颈部肌肉僵硬。根据磁共振成像（MRI）、病史和体格检查，他被诊断为放化疗后外展神经麻痹。针灸治疗方案主要基于眼周电针，辅以麦粒灸和温针，每周进行三次。经过一个月共17次针灸治疗后，患者患眼外展功能完全恢复。面部感觉异常和颈部僵硬也有明显改善。两个月的随访报告无复发。
针灸可能是放化疗后外展神经麻痹患者的一种保守治疗选择。
