Isolated Sixth Cranial Nerve Palsy as Initial Presentation of Pituitary Apoplexy: A Case Report

Pituitary apoplexy is a serious condition, which if left untreated, might lead to irreversible life-long complications. Hence, pituitary apoplexy should always be included in the differential diagnoses of a patient with an isolated sixth cranial nerve (CN) palsy. This report highlights the case of a...

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Published in:Curēus (Palo Alto, CA) CA), 2023-06, Vol.15 (6), p.e41154
Main Authors: Fadul, Abdalla, Demir, Gokhan, Safieh, Mohammad, Lebbe, Ahamed, Falamrz, Fatema, Alhassan, Ahmed T, Abdalla, ELMustafa, Fadul, Mohamed H, Elawad, Mohamed, Akbar, Raza A
Format: Article
Language:English
Subjects:
Case reports
Consciousness
Diplopia
Drug dosages
Emergency medical care
Hospitals
Hypertension
Insulin-like growth factors
Internal Medicine
Magnetic resonance imaging
Medicine
Neurological disorders
Neurology
Neurosurgery
Sinuses
Steroids
Surgery
Tumors
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Summary:Pituitary apoplexy is a serious condition, which if left untreated, might lead to irreversible life-long complications. Hence, pituitary apoplexy should always be included in the differential diagnoses of a patient with an isolated sixth cranial nerve (CN) palsy. This report highlights the case of a patient presenting with isolated CN palsy associated with pituitary apoplexy. Although pituitary adenomas are common, they seldom present with isolated abducent nerve palsy without any other CN involvement. The 47-year-old female patient presented with acute right eye pain, diplopia, and a squint. Examination revealed an isolated unilateral sixth CN palsy. Brain MRI showed a sellar and suprasellar mass suggestive of hemorrhagic pituitary apoplexy. The patient was transferred to neurosurgery and underwent transsphenoidal resection of a pituitary macroadenoma. Postoperative follow-up showed clinical improvement. It is, thus, imperative for physicians to have the knowledge to recognize an isolated sixth cranial nerve palsy and its associated causes.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.41154