Isolated Cranial Nerve VI Palsy and Neurosyphilis: A Case Report and Review of Related Literature

Garcia, Jao Jarro B.; Coralde, Jalea; Bagnas, Marjorie Anne C.; Khu, Kathleen Joy

doi:10.1016/j.idcr.2022.e01377

Cited by 3 publications

(1 citation statement)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indirect pressure, such as that from edema, hydrocephalus, or pseudotumor cerebri, results in downward pressure on the brainstem and consequent nerve injury as it stretches along the clivus. Other identified causes are decompensation; ophthalmic migraine; immunologic conditions, including multiple sclerosis, myasthenia gravis, and Creutzfeld-Jacob disease; thyroid-related diseases; tumors, such as craniopharyngiomas; infections, such as neurosyphilis; and macrovascular injuries [7][8][9][10]. Relatedly, patients with diabetes mellitus and hypertension are also at risk considering their vascular complications.…”

Section: Introductionmentioning

confidence: 99%

Isolated Abducens Nerve Palsy in the Setting of Isolated Sphenoid Sinusitis: A Case Report

Suarez,

Polmann,

Portnoy

et al. 2023

Cureus

View full text Add to dashboard Cite

The cranial nerves (CNs) are responsible for multiple functions, including extraocular mobility, facial sensation and movement, hearing, mastication, tongue movement and sensation, and swallowing. Beyond these vital roles, they can also demonstrate importance in their diagnostic value. Isolated or combined palsies provide insights into potential localizations and various underlying etiologies, including stroke, tumor, and infections that may guide further neurological evaluation. CN VI, the abducens nerve, singularly innervates the lateral rectus muscle, which is responsible for the abduction of the eyes. Despite its long anatomic trajectory, making it susceptible to intracranial injury, an isolated abducens nerve palsy is extremely rare. The most common clinical presentation includes headache, diplopia, and the inability to abduct the afflicted eye. This case report introduces a 71-year-old female with a medical history of malignancy and pancytopenia who presented to the emergency room with complaints of ear pain and swelling and subsequently developed diplopia secondary to unilateral CN VI palsy. Magnetic resonance imaging (MRI) revealed isolated sphenoid sinusitis for which she was clinically asymptomatic. She was treated with a regimen of ampicillin-sulbactam, an oral anti-inflammatory agent, and a tapered course of methylprednisolone with a rapid and complete resolution of the abducens nerve palsy and sinusitis. Acute isolated diplopia is an unusual neurologic condition prompting the need for rapid and thorough investigation. Although exceedingly rare and infrequently cited in the literature, isolated abducens nerve palsies secondary to sphenoid sinusitis should be entertained in the differential diagnosis of this presentation.

show abstract

Section: Introductionmentioning

confidence: 99%