Left 6th Nerve Palsy

76 male known case of DM n HTN presents with Diplopia on looking towards left side of visual field since 7 days. On examination left side Lateral Rectus Palsy (6th nerve palsy). No other cranial nerves involved. BP was 130/80 No other abnormalities in rest of neurological assessment. Diabetes is well controlled. CSF analysis reports are awaited. HIV, VDRL, TFT normal. His MRI Brain with Angiography report is as shown below. Kindly discuss differential diagnosis n management plan. Regards.

LikeAnswersShare
IT'S A..CASE OF.. ? CROSSED EYE.. DUE TO 6TH .. C..NERVE PALSY.. R/O.. CAUSES OF TH NERVE PALSY.. * CNS .. * HEAD INJURY.. * GRAVES DISEASE.. * COVID-19.. NEED'S CLINICOPATHOLOGICAL EVALUATION..ACCORDINGLY. WITH.. EXPERTS OPINION TO CONCLUDE DIAGNOSIS AND TREATMENT..
Tnx
0
Diabetic related 6th nerve palsy
Ma'am in MRI there is a vascular loop from pica pushing the subarachnoid part of 6th n
0

View 1 other reply

Decompression surgical intervention needed for complete recovery. Anyway, many thanks for posting this case as the vascular compression of 6th cranial nerve is a very rare phenomenon causing abducens palsy. I personally have seen few cases of 5th and 7th nerves compression by vascular loop, but not of 6th cranial n. Thank you again. Case may be published in Journal.
Apart from many neurological causes of acute onset 6th nerve palsy one has to consider that COVID 19 can also present with acute onset 6th nerve palsy, therefore RT PCR needs to be done Other causes are Meningitis with raised intracranial pressure Stroke Brain tumor Multiple sclerosis MRI brain would be helpful in further diagnosis
Strabismus due to Left Abducens nerve palsy
Agreed completely mam.

Cases that would interest you