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Updated: Jun 28, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Acute sixth nerve palsy in a young man, beware of the 'red herring'
E C O'Neill1, P P Connell, S Kadare
1Ophthalmology Department, Waterford Regional Hospital, Waterford, Ireland. evelynoneill@yahoo.com
Background:
Cranial nerve palsies has several etiologies including vascular insufficiency, neoplasm, trauma and inflammation. Isolated sixth nerve palsy is an extremely rare presenting feature of leukemia.
Aim:
We describe an unusual ocular presentation of a bilateral progressive sixth nerve palsy in a young male with a preceding head injury.
Conclusion:
Acquired sixth nerve palsies in young adults may be due to trauma but in the absence of a definitive history other systemic processes must be outruled. We describe a case of bilateral sixth nerve palsy in a patient with ALL with no obvious CNS involvement. Potential etiological mechanisms are discussed.
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