Isolated Lateral Rectus Palsy: A Case Report on Rare Neurological Manifestation of Dengue Viral Fever

Dengue fever is a mosquito-borne viral infection that spreads through Aedes aegypti mosquito and is a prevalent endemic disease in tropical countries such as India. Infecting approximately 50 to 100 million people annually in more than 100 countries, dengue as a disease is considered as a great public health challenge. Classically presenting symptoms include fever, arthralgia, headache, myalgia, and rash, but the incidence of neurological manifestations has recently been increasing due to changes in the virological characteristics of the dengue virus. Still, cranial mononeuropathy, involving the sixth cranial nerve, causing isolated lateral rectus paralysis is extremely rare. This case report describes a rare association between dengue viral fever causing unilateral lateral rectus palsy in a 31-year-old male with the presence of binocular diplopia in extreme right gaze. The patient was managed medically, and full ocular recovery was observed. This case highlights the importance to take dengue viral infection in consideration as a differential diagnosis in patients presenting with fever along with isolated sixth nerve palsy and discusses its diagnostic and therapeutic approach.