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Related Concept Videos

Cranial Nerves: Types Part I01:14

Cranial Nerves: Types Part I

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Cranial nerves are responsible for transmitting motor and sensory information between the brain and various parts of the body. There are twelve pairs of cranial nerves, with the first six being essential in sensory perception, motor control, and autonomic functions related to the head and neck.
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Somatic spinal reflexes are rapid, involuntary muscular responses to external stimuli that involve the somatic musculature and the spinal cord.
One of the most well-known somatic spinal reflexes is the stretch reflex, which is activated by the sudden stretching of a muscle. This reflex involves the activation of specialized sensory receptors called muscle spindles, which are located in the muscle tissue and detect changes in the length and speed of muscle contractions. When a muscle is suddenly...
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Spinal Nerves: Plexus I01:22

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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
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Updated: Oct 23, 2025

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Multiple Sclerosis Presenting with Sixth Nerve Palsy in a Child.

Nada Al-Yousuf1, Lolwah Aljutaili2, Aisha AlHuwais2

  • 1Department of Ophthalmology, King Abdullah Medical City, Manama, Kingdom of Bahrain.

International Medical Case Reports Journal
|August 20, 2021
PubMed
Summary

Pediatric multiple sclerosis (MS) can manifest as sixth nerve palsy, causing double vision. Early diagnosis using MRI and OCT is crucial for timely treatment and improved outcomes in children.

Keywords:
demyelinationdiplopialateral rectus palsyocular coherence tomography

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Area of Science:

  • Neurology
  • Ophthalmology

Background:

  • Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
  • Pediatric MS is rare and can present with diverse neurological symptoms.

Observation:

  • A 12-year-old female presented with double vision, imbalance, and paresthesia.
  • Ophthalmological examination revealed right eye abduction restriction.
  • Neurological examination indicated brisk reflexes and incoordination.

Findings:

  • MRI confirmed optic neuritis and demyelination, indicative of MS.
  • Ocular coherence tomography (OCT) showed subclinical optic neuritis with bilateral nerve fiber thinning.
  • Magnetic Resonance Imaging (MRI) and OCT are valuable tools for diagnosing pediatric MS and optic neuritis.

Implications:

  • Sixth cranial nerve palsy can be an initial presentation of MS in children.
  • High clinical suspicion is necessary for early diagnosis and treatment of pediatric MS.
  • Prompt treatment with corticosteroids and supportive therapies led to symptom resolution.