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Isolated sixth nerve palsy from pontine infarct
H Atilla1, C T Işikay, T Kansu
1Ankara University, School of Medicine, Department of Ophthalmology, Ankara, Turkey.
Acta Neurologica Belgica
|March 10, 2001
Summary
Isolated sixth nerve palsy can rarely result from a pontine infarct. This case highlights a lacunar infarct in the pons causing fascicular lesions, leading to isolated sixth nerve palsy.
Area of Science:
- Neurology
- Ophthalmology
Background:
- Isolated sixth nerve palsy is uncommon.
- The close anatomical relationship between the sixth cranial nerve fascicles and the pons makes this association rare.
Observation:
- A 62-year-old woman presented with diplopia and was diagnosed with left sixth nerve palsy.
- Ophthalmological examination showed 30 prism diopters of left esotropia and limited left eye abduction.
- Neurological examination was unremarkable.
Findings:
- Magnetic Resonance (MR) imaging revealed a lacunar infarct within the pons, indicative of a fascicular lesion.
- Cerebral angiography showed no abnormalities.
Implications:
- Pontine infarcts should be considered in the differential diagnosis of isolated sixth nerve palsies.
- This case underscores the importance of neuroimaging in evaluating isolated cranial nerve palsies.