title: Recurrent contralateral abducens nerve palsy in acute unilateral sphenoiditis.
abstract: OBJECTIVE
  We describe a patient who presented with recurrent, contralateral abducens nerve palsy resulting from acute sphenoiditis.
  
  
  METHODS
  Patient medical record and imaging studies were reviewed. A literature review of complications of sphenoiditis was performed.
  
  
  RESULTS
  Our patient presented with symptoms consistent with an upper respiratory tract infection, as well as severe headache, disequilibrium, and diplopia. Physical examination demonstrated left-sided sixth cranial nerve palsy. Imaging studies were consistent with right sphenoid sinus inflammatory disease. Her medical history was significant for a similar episode 9 years previously, which was managed medically. The current episode was treated acutely with antibiotics and prednisone. Upon resolution of her symptoms, she underwent an endoscopic sphenoidotomy.
  
  
  CONCLUSIONS
  Although cranial nerve palsies associated with isolated sphenoiditis have been reported, we describe a unique case of recurrent isolated sphenoiditis causing contralateral abducens nerve palsy. Acute management can be medical, with surgical therapy reserved for refractory cases or to prevent future episodes.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Gupta
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Michel
authors.forename: David M
authors.initials: DM
authors.lastname: Poetker
mesh_terms: D020434:Abducens Nerve Diseases / Q000209:etiology* / Q000628:therapy; D000208:Acute Disease; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D004172:Diplopia / Q000209:etiology; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D004856:Postural Balance; D011241:Prednisone / Q000627:therapeutic use; D012008:Recurrence; D013101:Sphenoid Sinus / Q000000981:diagnostic imaging; D015524:Sphenoid Sinusitis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D019980:Amoxicillin-Potassium Clavulanate Combination; D011241:Prednisone