Isolated abducens nerve palsy: MR imaging findings.

Depper, Mark H.; Truwit, Chip; Dreisbach, James N.; Kelly, W. M.

doi:10.2214/ajr.160.4.8456676

Cited by 21 publications

(14 citation statements)

References 4 publications

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“…The present case illustrates that isolated abducens palsy can be an anterolateral pontine syndrome, presumably affecting the intrapontine abducens nerve fascicle. In the review of Depper et al [8], 1 patient with acute multiple sclerosis showed a pontine lesion with the same location as our patient. This can support the point of view that the anterolateral pontine lesion causes isolated abducens palsy without involving other neural structures such as the corticospinal tract or medial lemniscus, regardless of the underlying etiology.…”

Section: Discussionsupporting

confidence: 79%

Isolated Abducens Nerve Palsy due to Anterolateral Pontine Infarction

Paik¹,

Kang²,

Sohn

2004

Eur Neurol

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Section: Discussionsupporting

confidence: 79%

Isolated Abducens Nerve Palsy due to Anterolateral Pontine Infarction

Paik¹,

Kang²,

Sohn

2004

Eur Neurol

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“…We found only two reported cases of abducens nerve enhancement demonstrated by 2D MRI [5,7], although the enhancing linear structure might possibly be a vein connecting the veins on the brain stem and the basilar plexus [10].…”

Section: Discussionmentioning

confidence: 99%

“…

IntroductionContrast enhancement of the cisternal portion of the oculomotor, [1,2,3,4,5] trochlear [6] and abducens [5,7,8,9,10] nerves on MRI has been reported in patients with ophthalmoplegia due to various causes. A few patients showed abducens nerve enhancement, while oculomotor nerve enhancement was observed relatively commonly, perhaps because the abducens nerve is too small to be delineated by 2-dimensional (2-D) MRI.

…”

mentioning

confidence: 99%

Abducens nerve enhancement demonstrated by multiplanar reconstruction of contrast-enhanced three-dimensional MRI

et al. 2001

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We describe contrast enhancement of the cisternal portion of the abducens nerve and discuss its clinical significance. We examined 67 patients with ophthalmoplegia using contrast-enhanced 3-dimensional (3D) MRI with multiplanar reconstruction along the nerves and found 16 patients (ten men, six women), aged 10-73 years (mean 34.4 years), with contrast enhancement of the abducens nerve. Of the 36 patients who had an abducens palsy, 14 (39%) showed contrast enhancement. In the 16 patients, 23 abducens nerves enhanced; 13 were symptomatic and 10 asymptomatic at the time. The causes were disseminated tumour (1), an inflammatory process (3), trauma (2), ischaemia (2) and autoimmune diseases (8), such as the Miller Fisher syndrome, acute ophthalmoparesis, polyneuropathy and multiple sclerosis. Abducens and/or oculomotor nerve enhancement was the only abnormality on MRI in the patients with traumatic or ischaemic neuropathy or autoimmune diseases. There were 14 patients who recovered fully within 1-6 months after treatment, and resolution of the enhancement correlated well with recovery.

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“…In fact, Depper et al suggested that MR imaging of patients with abducens nerve palsy requires a more focused examination as follows: T2-weighted images of the brainstem as well as the entire course of the sixth nerve, axial T1-weighted images before and after IV administration of contrast material for the course of the cisternal and petrous portions of the sixth nerve, and high-resolution coronal T1-weighted images before and after IV administration of contrast material for the prepontine cistern, parasellar region, and the posterior part of the orbit. 17 Hosoya et al demonstrated abducens nerve enhancement by multiplanar reconstruction of contrastenhanced three-dimensional MRI. They described that abducens nerve enhancement was the only abnormality on MRI in the patients with traumatic or ischaemic neuropathy or autoimmune diseases.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of the Causes and Magnetic Resonance Imaging Findings in Adult Isolated Non-traumatic Unilateral Abducens Palsy in Taiwan

Lee

Yen

2009

Neuro-Ophthalmology

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The objective of this study was to investigate the causes of acute isolated non-traumatic unilateral abducens palsy in adults and to evaluate the diagnostic relevance of Magnetic Resonance Imaging (MRI). This prospective study included a total of 40 patients presenting with acute isolated unilateral non-traumatic abducens palsy from January 2002 to June 2008 at Buddhst Tzu Chi General Hospital, Hualien. A standardized MRI protocol was performed within 1 week of the patient's first visit. In 23 patients (57.5%) a lesion was identified on the initial MRI relevant to the sixth nerve palsy. In 8 patients (20%) the cause was nasopharyngeal carcinoma. The MRI was positive in 4 out of 15 diabetic patients, and in 5 out of 12 patients with hypertension. MRI demonstrated the aetiology in 57.5% of cases of acute isolated non-traumatic unilateral abducens palsy, with nasopharyngeal carcinoma being a common cause in our study. We suggest a complete MRI study of the brain and the orbits, with axial, coronal and sagittal imaging, the use of intravenous contrast, and fat suppression techniques in acute adult isolated non-traumatic unilateral abducens palsy. etiology. 1-3 Bendszus et al. recommended that MRI should routinely be performed in patients presenting with acute sixth nerve palsy, while others suggested a medical evaluation and observation without initial neuroimaging in isolated presumed vasculopathic sixth nerve palsy. 4-7 The aims of this study were to investigate the causes of acute isolated nontraumatic unilateral abducens palsy in adults and to evaluate the diagnostic relevance of MRI. 174Neuroophthalmology Downloaded from informahealthcare.com by Michigan University on 11/04/14For personal use only.

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Isolated abducens nerve palsy: MR imaging findings.

Cited by 21 publications

References 4 publications

Isolated Abducens Nerve Palsy due to Anterolateral Pontine Infarction

Isolated Abducens Nerve Palsy due to Anterolateral Pontine Infarction

Abducens nerve enhancement demonstrated by multiplanar reconstruction of contrast-enhanced three-dimensional MRI

A Prospective Study of the Causes and Magnetic Resonance Imaging Findings in Adult Isolated Non-traumatic Unilateral Abducens Palsy in Taiwan

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