title: MRI in isolated sixth nerve palsies.
abstract: In previous studies the origin of the majority of isolated sixth nerve palsies was not clear or was ascribed to vascular disease. Our purpose was determine how frequently a causative lesion was demonstrated on MRI in patients with an acute unilateral sixth nerve palsy. We performed a prospective study of 43 patients using a standardised protocol. In 27 patients (63%) a lesion was identified on the initial MRI relevant to the sixth nerve palsy; 21 (49%) were found to have a tumour or tumour-like lesion; the frequency of presumed vasculopathy in this group was 15%. There were 16 patients (37%) with an initially normal MRI, of whom 10 (62%) had a history of vasculopathy, a significantly different proportion from the group of patients with a visible causative lesion. MRI after 3-6 months was normal in all patients with a normal initial MRI. We suggest that MRI should routinely be performed in patients presenting with an acute sixth nerve palsy, even those with evidence of a vasculopathy. If the symptoms regress spontaneously and there is a history of vasculopathy, follow-up MRI is not necessary.
authors.affiliation: Department of Neuroradiology, University of Würzburg, Germany. bendszus@neuroradiologie.uni-wuerzburg.de
authors.forename: M
authors.initials: M
authors.lastname: Bendszus
authors.forename: A
authors.initials: A
authors.lastname: Beck
authors.forename: M
authors.initials: M
authors.lastname: Koltzenburg
authors.forename: G H
authors.initials: GH
authors.lastname: Vince
authors.forename: D
authors.initials: D
authors.lastname: Brechtelsbauer
authors.forename: T
authors.initials: T
authors.lastname: Littan
authors.forename: H
authors.initials: H
authors.lastname: Urbach
authors.forename: L
authors.initials: L
authors.lastname: Solymosi
mesh_terms: D000010:Abducens Nerve / Q000473:pathology*; D020434:Abducens Nerve Diseases / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies