Isolated bilateral abducens nerve palsy due to an inflammatory process within the sella and parasellar regions.
Isolated bilateral abducens nerve palsy raises concern about a serious intracranial condition. Abducens nerve palsy is a common isolated palsy due to its susceptibility to injury along its long course. Non-traumatic isolated abducens nerve palsy is often caused by a mass that indirectly stretches and compresses the nerve. Pathological processes directly causing bilateral isolated involvement of the abducens nerve are rare. We describe a 24-year-old man who presented with isolated bilateral abducens nerve palsy. Radiological imaging and laboratory tests were consistent with an aggressive bacterial infectious process located in the sellar region with parasellar extension. If promptly addressed, sixth cranial nerve palsy appears to be reversible with aggressive medical therapy and endoscopic sinus surgery.
Department of Neurological Surgery, University of Southern California, Keck School of Medicine, 1200 North State Street, Suite 3300, Los Angeles, CA 90033, USA. Electronic address: Joshuabakh@gmail.com.
Joshua
J
Bakhsheshian
University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
Michelle S
MS
Hwang
Department of Neurological Surgery, University of Southern California, Keck School of Medicine, 1200 North State Street, Suite 3300, Los Angeles, CA 90033, USA.
Ben A
BA
Strickland
Department of Emergency Medicine, Cook County (Stroger) Hospital, Chicago, IL, USA.
Basem
B
Khishfe
D020434:Abducens Nerve Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D008297:Male; D010256:Paranasal Sinuses / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
Abscess; Aneurysm; Cranial nerve palsy; Phlegmon; Sixth nerve; Streptococcus