Clinical and laboratory predictors of recovery outcomes in isolated abducens nerve palsy.

OBJECTIVE

To investigate the differences in clinical characteristics, laboratory parameters, and radiological findings between patients with complete and incomplete recovery of isolated abducens nerve palsy (IANP).

METHODS

We retrospectively analyzed 107 patients diagnosed with IANP from 3 centers. Individuals with other cranial nerve involvement or neurological deficits were excluded. Data on demographics, clinical features, laboratory results, and imaging findings were collected and analyzed.

RESULTS

Among 107 patients, 66 achieved complete recovery, while 41 had incomplete recovery. Analysis of clinical characteristics showed that the distribution pattern of the side of palsy (left, right, or bilateral, P = 0.018), etiology (P = 0.019) and preceding infection (P = 0.044) were significantly correlated with poor outcomes. Analysis laboratory results revealed that higher erythropoietin (EPO) levels were also significant associated with incomplete recovery (OR = 1.126, 95% CI 1.026-1.236, P = 0.013), while imaging findings and cerebrospinal fluid (CSF) parameters showed no significant association with recovery outcomes. Multivariate analysis identified four factors were associated with incomplete recovery: preceding infection (OR = 8.690, 95% CI 1.219-61.946, P = 0.031), trauma history (OR = 13.389, 95% CI 1.257-142.604, P = 0.032), time of symptom onset (OR = 1.033, 95% CI 1.002-1.064, P = 0.035), and EPO levels (OR = 1.139, 95% CI 1.035-1.253, P = 0.008).

CONCLUSIONS

Preceding infection, trauma history, time of symptom onset, and EPO levels were identified as predictors of incomplete recovery in IANP patients, while imaging findings and CSF parameters showed no significant association with recovery outcomes. These findings provide new clinical insights by guiding prognostic assessment (e.g., preceding infection history and monitoring EPO levels) and highlighting modifiable (e.g., prompt medical intervention) and non-modifiable (e.g., trauma history) factors that personalized management strategies for IANP patients.