A Case of Traumatic Isolated Unilateral Sixth Cranial Nerve Palsy

Abstract

Vierlia, Wino Vrieda

Traumatic isolated sixth cranial nerve palsy is a rare condition that has been reported to be as low as 1% to 2, 7% following traumatic brain injury. The sixth nerve innervates the ipsilateral lateral rectus which abducts the eye. Isolated loss of lateral gaze with no other cranial nerve signs and muscular entrapment is thought to be resulted from an injury to the peripheral nerve along its course from the brain stem to the lateral rectus. We presented a case of traumatic isolated unilateral sixth cranial nerve palsy in a female patient with diplopia and restriction left eye movement to lateral following head trauma after accident. Head Computed Tomography (CT) scan showed left frontal bone fracture involving the lateral wall of the orbit and also left retro orbital hemorrhage with no other lesions noted in the brain. Eye examination revealed isolated sixth cranial nerve palsy with normal vision of both eyes. Here we discussed about the possible mechanism, differential diagnosis and also management of the patient.

PDF