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Recurrent isolated sixth nerve palsy in children

W P Boger, C A Puliafito, E H Magoon

    Annals of Ophthalmology
    |March 1, 1984
    PubMed

    Insights

    Recurrent sixth nerve palsy in children often lacks identifiable causes, challenging the notion that most cases are post-infectious. Further research is needed to understand this benign condition.

    Area of Science:

    • Ophthalmology
    • Pediatric Neurology

    Background:

    • Sixth nerve palsy (also known as abducens nerve palsy) is a common cause of acute-onset strabismus in children.
    • While often attributed to post-infectious or post-viral causes, the etiology of isolated sixth nerve palsy remains uncertain.

    Observation:

    • This study observed six children with recurrent sixth nerve palsy, averaging six weeks per episode.
    • Recurrences were frequent, with an average interval of 1.3 years, and often occurred on the same side (ipsilateral).

    Findings:

    • No identifiable intracranial processes were associated with these recurrent palsies.
    • The findings suggest that not all recurrent sixth nerve palsies in children are post-infectious, indicating a potentially larger group of 'benign' isolated cases than previously recognized.

    Implications:

    • The etiology of isolated, recurrent sixth nerve palsy in children remains largely unknown.
    • This highlights the importance of considering recurrent sixth nerve palsy as a distinct entity, separate from single-episode palsies that may have more serious underlying causes.
    • Diagnosis of benign sixth nerve palsy is retrospective, emphasizing the need for careful observation.

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