Sixth nerve palsy for PACES

The R/L eye has a lateral gaze palsy.
They have diplopia.

Quick recap of the innervation of the muscles of the eye:

What causes do you know for an isolated abducens palsy?
  • most commonly caused by vasculopathic causes, such as diabetes mellitus, hypertension, atherosclerosis
  • the abducens nerve arises from the base of the brain (between the pons and the medulla) so it is often the first cranial nerve to be affected by any rise in intracranial pressure
  • other causes for a palsy along its course include:
    • implication in otitis media/mastoiditis at the apex of the petrous temporal bone, leading to Gradenigo's syndrome (otitis media, lateral gaze palsy and pain in distribution of the trigeminal nerve)
    • complications in the cavernous sinus, for example thrombosis, infection or infiltration
    • rarely: problems in the orbit.
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