Clinical profile of sixth nerve palsy

Abstract

Aim: This study aimed to assess various causative factors of sixth nerve palsy, the recovery rate of sixth nerve palsy, and to develop the diagnostic algorithm for sixth nerve palsy. Methods: This was a hospital-based retrospective observational study. For this study, electronic case records of all patients with sixth cranial nerve palsy who were followed up for 6 months were collected. The study duration was between June 2017 and May 2022. Characteristics such as the age of onset, gender, presence of any systemic conditions, and laterality were analysed. Results: Total number of patients was 82. 63% were males and rest were 37% females. 62% had systemic involvement, and 38% had no systemic involvement. Among systemic illnesses, diabetes was the most common cause of isolated sixth nerve palsy (61%). The most common cause of sixth nerve palsy was due to vasculopathy (49%). Trauma (11%) was the second leading cause of sixth nerve palsy; the tumour was very rare in our study about 1%. Sixth nerve palsy in idiopathic intracranial hypertension amounting to about 5%. We were unable to identify the cause in certain patients (16%); post-viral aetiology consists of about 1%, cortical vein thrombosis to about 1%, cavernous vein thrombosis to about 2%, aneurysm consists about 3%, congenital cause amounting to about 5%, inflammatory accounts about 6%. Recovery rate among sixth nerve palsy: 87% had complete recovery in our study; vasculopathy had a 100% recovery rate. In contrast, trauma had 50% recovery and 50% non-recovery rate. In contrast, tumour and congenital had no recovery rate. Conclusion: Ischaemia followed by trauma is the common aetiology raising concerns about the health issues of young Indians and road safety.

Keywords

• abducens palsy
• isolated cranial nerve palsy
• sixth cranial nerve palsy
• trauma
• tumour
• vasculopathy