Acute sixth nerve palsy in a young man, beware of the ‘red herring’

Background Cranial nerve palsies has several etiologies including vascular insufficiency, neoplasm, trauma and inflammation. Isolated sixth nerve palsy is an extremely rare presenting feature of leukemia. Aim We describe an unusual ocular presentation of a bilateral progressive sixth nerve palsy in...

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Bibliographic Details
Published in:Irish journal of medical science 2010-06, Vol.179 (2), p.301-303
Main Authors: O’Neill, E. C., Connell, P. P., Kadare, S., Tormey, P. T.
Format: Article
Language:English
Subjects:
Abducens Nerve Diseases - diagnosis
Abducens Nerve Diseases - pathology
Adolescent
Antineoplastic Agents - therapeutic use
Case Report
Cranial Nerve Neoplasms - diagnosis
Cranial Nerve Neoplasms - drug therapy
Cranial Nerve Neoplasms - pathology
Family Medicine
General Practice
Humans
Internal Medicine
Intracranial Pressure
Male
Medicine
Medicine & Public Health
Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Superior Vena Cava Syndrome
Vision Disparity
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Summary:Background Cranial nerve palsies has several etiologies including vascular insufficiency, neoplasm, trauma and inflammation. Isolated sixth nerve palsy is an extremely rare presenting feature of leukemia. Aim We describe an unusual ocular presentation of a bilateral progressive sixth nerve palsy in a young male with a preceding head injury. Conclusion Acquired sixth nerve palsies in young adults may be due to trauma but in the absence of a definitive history other systemic processes must be outruled. We describe a case of bilateral sixth nerve palsy in a patient with ALL with no obvious CNS involvement. Potential etiological mechanisms are discussed.
ISSN:0021-1265
1863-4362
DOI:10.1007/s11845-008-0245-9