Abducens nerve palsy, or sixth nerve palsy, results in weakness of the ipsilateral lateral rectus muscle.
Patients present with horizontal diplopia with an inability to abduct the ipsilateral eye, thereby resulting in an esotropia (nasal deviation of the eye).
The abducens nerve has the longest subarachnoid course of all the cranial nerves.
- increased intracranial pressure
- results in downward displacement of the brainstem, causing stretching of the sixth nerve secondary to its location within Dorello's canal
- microvascular (e.g. diabetes mellitus)
- subarachnoid space pathology (e.g. subarachnoid hemorrhage, meningitis, neurosarcoidosis, neoplasm)
- cavernous sinus pathology (e.g. cavernous sinus thrombosis)
- pontine pathology (e.g. stroke, neoplasm, multiple sclerosis)
- intracavernous internal carotid artery aneurysm
- 1. Moster ML, Savino PJ, Sergott RC, Bosley TM, Schatz NJ. Isolated sixth-nerve palsies in younger adults. (1984) Archives of ophthalmology (Chicago, Ill. : 1960). 102 (9): 1328-30. Pubmed
- 2. Depper MH, Truwit CL, Dreisbach JN, Kelly WM. Isolated abducens nerve palsy: MR imaging findings. (1993) AJR. American journal of roentgenology. 160 (4): 837-41. doi:10.2214/ajr.160.4.8456676 - Pubmed