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Oh: A Case of Idiopathic Unilateral Abducens Nerve Palsy in an Adolescent Patient
Case Report

Journal of the Korean Ophthalmological Society 2017; 58(9): 1110-1114.

Published online: 18 September 2017

DOI: https://doi.org/10.3341/jkos.2017.58.9.1110

A Case of Idiopathic Unilateral Abducens Nerve Palsy in an Adolescent Patient

Shin Yeop Oh, MD

Department of Ophthalmology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Address reprint requests to: Shin Yeop Oh, MD. Department of Ophthalmology, Samsung Changwon Hospital, #158 Paryong-ro, Masanhoewon-gu, Changwon 51353, Korea. Tel: 82-55-233-5400, Fax: 82-55-233-8070, mojili914@hanmail.net

Received 11 May 2017       Revised 24 July 2017       Accepted 17 August 2017

©2017 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of idiopathic unilateral abducens nerve palsy in an adolescent patient.

Case summary

A healthy 14-year-old boy presented with binocular horizontal diplopia that started that same day. He did not have any history of trauma, vaccination or infectious disease and showed no other neurological signs. The best corrected visual acuity of both eyes was 20/20. Slit lamp and fundus examinations revealed no other abnormalities. On the alternative prism cover test, he had 6 prism diopter (PD) esotropia with −1 degree abduction limitation in the left eye. After 1 week, the abduction limitation in the left eye was progressed to −3.5 degrees, so we performed brain imaging. The brain magnetic resonance imaging (MRI) and systemic evaluation (serologic test, cerebrospinal fluid examination) were normal therefore, we suspected idiopathic unilateral abducens nerve palsy. Thus, intravenous steroid injection was started, and the patient was partially recovered after 5 days of treatment. At 5 weeks after presentation, diplopia and abduction limitation in the left eye were completely resolved, and recurrence was not found during the 1 year of follow-up.

Conclusions

We report a case of progressive idiopathic unilateral abducens nerve palsy in an adolescent which has resolved completely after intravenous steroid treatment in a short period.

Keywords: Abducens nerve palsy, Adolescent, Diplopia, Idiopathic

Figures and Tables

Figure 1

Gaze photographs 1 week after the initial presentation. After 1 week, there was esodeviation with abduction limitation in the left eye.

jkos-58-1110-g001
Figure 2

Gaze photographs 4 weeks after the initial presentation. After 4 weeks, there was 4 PD esodeviation of the left eye at left gaze position.

jkos-58-1110-g002

Notes

This study was presented as an e-poster at the 117th Annual Meeting of the Korean Ophthalmology Society 2017.

Conflicts of Interest The authors have no conflicts to disclose.

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