DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for fourth cranial nerve palsy — screening already-approved drugs against its 1-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleFourth cranial nerve palsy maps to a 1-gene Open Targets module — the target space DeCure's AI scientist screens approved drugs against.
DeCure.ai methodSignature reversal (LINCS) plus network proximity (STRING) rank already-approved drugs likely to perturb this module — the same engine that produces DeCure.ai's repurposing hypotheses.
Repurposing thesisScreening approved medicines against this disease module, then publishing the evidence for the strongest candidate. Known pharmacology and human exposure data make the first question sharper — they do not establish safety or efficacy in a new indication.
Research record
01
ResearchComing soon
Candidate research + dossier — target rationale, drug-repurposing thesis and evidence pack.proof: Published dossier + on-chain hash
02
ValidationComing soon
In-vitro biological validation at a contract research org (CRO).proof: CRO contract + in-vitro report
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Peer review & paperComing soon
Peer-reviewed paper published open-access (preprint + journal).proof: DOI + open-access link + on-chain hash
Current lead
No approved-drug candidate for fourth cranial nerve palsy is corroborated in the literature DeepSearch retrieved. Some conditions are managed with non-pharmacological care — a device, surgery or physical therapy — rather than a medicine; that may be the case here, or the literature we found may simply be too sparse yet to support a drug-repurposing angle.
What the evidence adds up to
In a retrospective study of 35 patients with acquired unilateral fourth cranial nerve palsy followed for at least six months, complete recovery occurred in 23 patients (65.7%), with an average time to recovery of 3.91 months. Trauma was the most common cause (40.0%), followed by ischaemia (37.1%), intracranial mass (11.4%), other causes (8.6%), and idiopathic cases (2.9%). Patients who did not achieve complete recovery had a significantly higher degree of palsy and larger fundus torsion. Severe oculomotor limitation, large fundus excyclotorsion, and an intracranial mass as the cause were each associated with a higher risk of incomplete or no recovery.
A separate ten-year retrospective analysis of third, fourth, and sixth cranial nerve palsies found that trochlear nerve palsy was most commonly caused by trauma (31.6%). Among all three nerve types, the best recovery outcomes for trochlear nerve palsy were seen in cases due to ischaemic events. Logistic regression across all cranial nerve palsies showed that symptom onset in less than seven days and involvement of only a single nerve were significantly associated with better long-term outcomes, with adjusted odds ratios of 1.73 and 2.56 respectively.
Neither study tested any drug treatment for fourth cranial nerve palsy. One case report describes a patient with Bell’s palsy (a different condition affecting the facial nerve) who recovered after homoeopathic treatment, but this is a single uncontrolled observation and does not apply to fourth nerve palsy. A general review of facial nerve palsy management notes that the most common cause is idiopathic Bell’s palsy, accounting for about 50% of cases, but again this is a separate nerve.
What remains missing for fourth cranial nerve palsy specifically are prospective trials, any drug intervention tested against natural history, and a clear understanding of which patients with traumatic or ischaemic causes might benefit from early medical or surgical treatment. The existing data are retrospective, from single centres, and do not stratify patients by severity or timing of intervention in a way that could guide a drug-repurposing study.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Clinical ophthalmology · 2024 · 11 citations · open access
Retrospective Analysis of Factors Related to the Long-Term Recovery of Third, Fourth, and Sixth Cranial Nerve Palsy with Etiologies and Clinical Course in a Tertiary Hospital
AbstractPurpose: Although various studies have explored the causes and clinical aspects of cranial nerve palsies, there remains a significant gap in understanding the prognostic factors that influence outcomes. In this study, we sought to address this gap by investigating the incidence, etiologies, clinical courses, and factors associated with long-term recovery, with the aim of enhancing the knowledge base in this field and providing valuable insights for improved patient care. Patients and Methods: This retrospective study evaluated the data gathered from subjects who had third, fourth, and sixth cranial nerve palsy at the ophthalmology outpatient clinic of Phramongkutklao Hospital between April 1, 2012, and April 30, 2022. Results: Among the three nerves, abducens nerve palsy was the most prevalent finding by most commonly involved. Our study revealed that ischemic and compressive lesions were the most common etiology of oculomotor nerve palsy, comprising 24.6% each. In addition, the most common etiology of trochlear and abducens nerve palsy was trauma, at 31.6% and 27.1%, respectively. Compared with the other nerves, oculomotor nerve palsy was associated with a shorter duration onset of symptoms and recovery period. The best recovery outcomes among the various etiologies were inflammation, ischemic events, and trauma in oculomotor, trochlear, and abducens nerve palsy, respectively. Logistic regression revealed that an onset of < 7 days and isolated nerve involvement were significantly associated with good long-term outcomes, with an adjusted odds ratio of 1.73 (95% confidence interval, 1.03– 2.89) and 2.56 (95% confidence interval, 1.21– 5.39) adjusted for the type of cranial nerve palsy, aged at 50 years, sex, diabetes mellitus, hypertension, dyslipidemia, onset at 7 days, and number of cranial nerves involved, respectively. Conclusion: The onset of symptoms in less than 1 week and isolated nerve involvement were associated with better prognosis in subjects with third, fourth, and sixth cranial nerve palsy. Plain Language Summary: This study aimed to fill a gap in our understanding of cranial nerve palsies, which affects eye movements and coordination. We investigated the causes, clinical courses, and factors influencing long-term recovery in patients with third, fourth, and sixth cranial nerve palsy. We studied the data obtained from patients at an ophthalmology clinic over a 10-year period. Abducens nerve palsy was the most common among these conditions. Ischemia and compression were observed to be the leading causes of oculomotor nerve palsy, whereas trauma was the primary cause of trochlear and abducens nerve palsy. Oculomotor nerve palsy had the shortest onset and recovery time compared with other nerves. The best recovery outcomes were observed in cases of inflammation, ischemic events, and trauma for oculomotor, trochlear, and abducens nerve palsy, respectively. The study also found that a rapid onset of symptoms in less than 7 days and involvement of only one nerve were associated with better long-term outcomes. This information can help doctors provide better care and more accurate prognoses to patients with cranial nerve palsies. Keywords: oculomotor, trochlear, abducens, nerve palsy, outcome, prognosis
Journal of Neuro-Ophthalmology · 2021 · 3 citations
Clinical Characteristics for Predicting Recovery of Acquired Fourth Cranial Nerve Palsy
AbstractBACKGROUND: Fourth cranial nerve palsy is the most common disease diagnosed in patients with vertical diplopia. Although it is reported to present a good prognosis, there are currently no agreed on prognostic factors that anticipate the recovery of the palsy other than the etiology. The purpose of this study was to investigate the prognostic factors of acquired fourth cranial nerve palsy. METHODS: The medical records of consecutive patients diagnosed with acquired unilateral fourth cranial nerve palsy from 2010 to 2020 and followed up for ≥6 months were retrospectively reviewed. The cause and degree of palsy, ocular deviation (horizontal, vertical, and cyclo), and fundus torsion were reviewed. The cause of palsy was classified as ischemic, traumatic, intracranial mass, others, or idiopathic. Patients were divided into 2 groups according to palsy recovery: complete recovery (group CR) or not CR (group NCR). The clinical characteristics of the 2 groups were compared, and the risk factors for incomplete recovery were investigated. RESULTS: Thirty-five patients (25 men) were included in the study. The average age was 55.94 ± 16.11 years. CR was achieved in 23 patients (65.7%), and the time to recovery was 3.91 ± 4.03 months. The most common cause was traumatic (40.0%), followed by ischemia (37.1%), intracranial mass (11.4%), others (8.6%), and idiopathic (2.9%). The degree of palsy and fundus torsion was significantly higher in group NCR (P = 0.010 and P = 0.001). Severe oculomotor limitation, large fundus torsion, and intracranial mass cause rather than ischemic cause indicated a higher risk of incomplete or no recovery (P = 0.016, P = 0.009, and P = 0.043). CONCLUSION: Identifying whether a patient has an intracranial mass, severe oculomotor limitation, or large fundus excyclotorsion may be useful for predicting the recovery of acquired unilateral fourth cranial nerve palsy.
Journal of Integrated Standardized Homoeopathy · 2023 · 1 citations · open access
A case of Bell’s palsy successfully treated with homoeopathy
AbstractBell’s palsy is an acute unilateral facial palsy of the lower motor neuron type predominantly affecting middle aged men. Although exact aetiology is unknown, but probable causes include entrapment of the nerve at the mental foramen and vasospasm due to external factors. Surgical management along with medical management provides an assuring relief for the Bell’s palsy sufferers, may produce adverse effects such as facial nerve palsy or post-surgical synkinesis. Homoeopathic medicines, when selected based on signs and symptoms, act on the vital force dynamically and gently restore the nerve functioning to normal. Here, we present a case of left-sided Bell’s palsy recovered with homoeopathic medicines prescribed on the basis of causation and side affinity. The recovery was assessed by the House Brackmann scale and the quality of life was assessed using the modified Naranjo criteria.
British Journal of Hospital Medicine · 2008 · 1 citations
Facial nerve palsy: assessment and management
AbstractThe facial nerve (cranial nerve VII) is the most common site of unilateral cranial nerve palsy. Patients with facial nerve palsy may present in either the emergency department or primary care setting and it is important to be familiar with appropriate assessment and management. The most common cause of facial palsy is idiopathic (otherwise known as Bell's palsy), accounting for around 50% of cases. This is essentially a diagnosis of exclusion and therefore a systematic approach to history, examination and investigation is required to ensure that the correct diagnosis is made.
International Journal of Surgery Case Reports · 2025 · 0 citations · open access
The outcome of lateral rectus extirpation in a case of traumatic third cranial nerve palsy: A case report
AbstractINTRODUCTION AND CLINICAL IMPORTANCE: To present a case of traumatic third cranial nerve palsy and discuss the management challenges associated with this condition. CASE PRESENTATION: A 27-year-old male patient was referred to our hospital following a road traffic accident that resulted in multiple injuries, including traumatic brain injury, orbital injury. The patient presented with left complete upper lid ptosis, a fixed dilated pupil, and restricted extraocular muscle movements in the left eye except abduction with large exotropia >90 PD and hypotropia 25 PD diagnosed as left oculomotor nerve palsy. Imaging studies confirmed the presence of multiple orbital fractures. CLINICAL DISCUSSION: Oculomotor nerve palsy is a common and significant clinical finding, accounting for 30 % of all cranial nerve palsies. Third nerve palsy presents the greatest challenge, as it affects four of the six extraocular muscles, necessitating a different treatment approach. Managing patients with this condition is challenging, as the outcomes of various surgical techniques have generally been viewed as unsatisfactory. The primary goal of surgery is to achieve good ocular alignment in the primary position, but it is rarely effective in restoring measurable binocular function. CONCLUSION: This case report highlights the complex nature of managing traumatic third cranial nerve palsy, which requires a comprehensive approach to address the patient's visual and functional impairments. Further research and advancements in surgical techniques are needed to improve outcomes for patients with this condition.
Disease module: DeepOracle (Open Targets). Structures: RDKit from PubChem SMILES. Literature: retrieved by DeepSearch across 234,678,978 indexed works (targeted per-candidate search), resolved on OpenAlex.
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