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Cranial mononeuropathy VI
Abducens paralysis; Abducens palsy; Lateral rectus palsy; VIth nerve palsy; Cranial nerve VI palsy; Sixth nerve palsy; Neuropathy - sixth nerve
Cranial mononeuropathy VI is a nerve disorder. It affects the function of the sixth cranial (skull) nerve. As a result, the person may have double vision.
Causes
Cranial mononeuropathy VI is damage to the sixth cranial nerve. This nerve is also called the abducens nerve. It helps you move your eye sideways toward your temple.
Disorders of this nerve can occur with:
-
Brain
aneurysms
Aneurysms
An aneurysm is an abnormal widening or ballooning of a part of an artery due to weakness in the wall of the blood vessel.
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Nerve damage from diabetes(
diabetic neuropathy
)
Diabetic neuropathy
Nerve damage that occurs in people with diabetes is called diabetic neuropathy. This condition is a complication of diabetes.
ImageRead Article Now Book Mark Article - Gradenigo syndrome (which also causes discharge from the ear and eye pain)
- Tolosa-Hunt syndrome, inflammation of the area behind the eye
- Increased or decreased pressure in the skull
-
Infections (such as
meningitis
or
sinusitis
)
Meningitis
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
ImageRead Article Now Book Mark ArticleSinusitis
Sinusitis is present when the tissue lining the sinuses become swollen or inflamed. It occurs as the result of an infection from a virus, bacteria, ...
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Multiple sclerosis (
MS
), a disease that affects the brain and spinal cord
MS
Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord (central nervous system).
ImageRead Article Now Book Mark Article - Pregnancy
- Stroke
- Trauma (caused by head injury or accidentally during surgery)
- Tumors around or behind the eye
In some people, there is no clear cause.
Because there are common nerve pathways through the skull, the same disorder that damages the sixth cranial nerve may affect other cranial nerves (such as the third or fourth cranial nerve).
Symptoms
When the sixth cranial nerve doesn't work properly, you can't turn your eye outward toward your ear. You can still move your eye up, down, and toward the nose, unless other nerves are affected.
Symptoms may include:
-
Double vision
when looking to one side
Double vision
There are many types of eye problems and vision disturbances, such as: HalosBlurred vision (the loss of sharpness of vision and the inability to see ...
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- Pain around the eye
Exams and Tests
Tests often show that one eye has trouble looking to the side while the other eye moves normally. An examination shows the eyes do not line up either at rest or when looking in the direction of the weak eye.
Your health care provider will do a complete examination to determine the possible effect on other parts of the nervous system. Depending on the suspected cause, you may need:
- Blood tests
-
Head imaging study (such as an
MRI
or
CT scan
)
MRI
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
ImageRead Article Now Book Mark ArticleCT scan
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
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Spinal tap
(lumbar puncture)
Spinal tap
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...
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You may need to be referred to a doctor who specializes in vision problems related to the nervous system (neuro-ophthalmologist).
Treatment
If your provider diagnoses swelling or inflammation of, or around the nerve, medicines called corticosteroids may be used.
Sometimes, the condition disappears without treatment. If you have diabetes, you'll be advised to keep tight control of your blood sugar level .
Blood sugar level
A blood glucose test measures the amount of a sugar called glucose in a sample of your blood. Glucose is a major source of energy for most cells of t...
The provider may prescribe an eye patch to relieve the double vision. The patch can be removed after the nerve heals.
Outlook (Prognosis)
Treating the cause may improve the condition. Even when no cause is found, recovery is usually complete.
Possible Complications
Complications may include permanent vision changes.
When to Contact a Medical Professional
Call your provider if you have double vision.
Prevention
There is no way to prevent this condition. People with diabetes may reduce the risk by controlling their blood sugar.
References
Azarmina M, Azarmina H. The six syndromes of the sixth cranial nerve. J Ophthalmic Vis Res . 2013;8(2):160-171. PMCID: PMC3740468 www.ncbi.nlm.nih.gov/pmc/articles/PMC3740468 .
Rucker JC, Thurtell MJ. Cranial neuropathies. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 104.
-
Central nervous system - illustration
The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.
Central nervous system
illustration
Review Date: 5/30/2016
Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
