A case report of isolated abducens nerve palsy: idiopathic or ophthalmoplegic neuropathy?

An Atypical Radiologic Presentation of Right Sixth Lateral Rectus Palsy: A Case Report

Isolated ocular palsies are often associated with a benign process in the pediatric population but early diagnosis is critical to exclude any serious pathology. In this case, a six-year-old female with no significant past medical history presented with isolated right-eye medial deviation. The patient reported right-eye medial deviation for the past several weeks and associated double vision, but denied any pain with eye movements, other cranial nerve changes, or headaches. This case highlights the key radiologic finding which may ultimately allow for a leading diagnosis and inform further management in cases of isolated ocular nerve palsy.

Isolated Bilateral Abducens Palsy as a Presenting Feature of Multi-Infarct State: A Case Report

Isolated abducens palsy is a rare clinical entity. The usual causes of bilateral sixth nerve palsy are head trauma, tumor (skull base), aneurysm, and ischemic stroke. Bilateral abducens palsy without any other neurological deficit secondary to ischemic stroke is a rare clinical presentation. We present a case of a 78-year-old male without any comorbidities with a history of diplopia for the last two months. Physical examination was unremarkable except for bilateral sixth nerve palsy. MRI brain showed the chronic ischemic area in the pons, bilateral basal ganglia, deep white matter, and periventricular region of bilateral frontal, temporal, parietal, and occipital lobe. This report highlights an unusual presentation of ischemic stroke as isolated bilateral abducens palsy without any other focal neurological deficit.