Sixth nerve palsy

Sixth nerve palsy is being considered as one of the important clinical problem in case of persons in various countries. Various pressure-causing lesions cause sixth cranial nerve palsy anywhere from its origin to the insertion points.


The damage may be caused by the tumor like growths or any other tissue swelling with growth of fibrous mass leading to the changes in pressure over this important nerve.

Since the sixth nerve is passing over the selected regions of the temporal bone, the damage to the concerned regions of the temporal bones ultimately lead to the development of some kinds of pressure.

Hence, the general functions of this concerned nerve regions get highly affected causing the related symptomatology in the affected persons. Most of the affected persons complain that the onset of this kind of problem was found to be sudden without any problems in the eyes or vision earlier.

Pituitary adenoma or meningioma, fistula or inflammatory changes in the region of this nerve may become the causal factors that may lead to the sixth nerve palsy. The affected patients will have the abduction of the eyes especially during the involvement of pathways of both the sides of this nerve.

There may be headache in some patients. However, the headache may not be present in all cases. Most of the occasions, the older patients get affected in case of damage to the sixth nerve palsy.

Ischemic infarcts resulting from the increased blood pressure or the deranged glucose metabolism finally leads to this kind of nerve problem in the affected person.
There may be diplopia that may get worsened at distance.

Most of the times, the diagnosis may not be carried out fully and it needs extensive diagnostic skills for a proper diagnosis of the sixth nerve palsy.

However, the differential diagnosis needs to be carried out in a systematic manner because condition like myasthenia gravis may cause the conditions that reveal the same kind of clinical signs.

Unilateral occlusion may temporarily cause recovery from this condition. In many cases, the condition may get automatically resolved in a matter of three to four months.

If the condition is persisting, then one can assume that the case is in a worsened state and in such cases the recovery may be per haps difficult in general.

Fresnel prism correction may be carried out certain times in order to correct the diplopia in case of affections of persons with the sixth nerve palsy. If the condition is not cured, then you may have to go in for MRI. The patient needs to be examined with detailed hematological and biochemical examinations in such situations.


Some times, some specific biochemical parameter will be of helpful in ruling out some clinical disorders, which would have caused signs that are more or less similar to those of sixth nerve palsy. Sixth nerve palsy is to be understood in detail by a medical expert.




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