Causes of isolated recurrent ipsilateral sixth nerve palsies in older adults: a case series and review of the literature

Clinical Ophthalmology
Jane W Chan, Jeff Albretson

Abstract

The etiology of recurrent isolated sixth nerve palsies in older adults has not been well described in the literature. Sixth nerve palsies presenting with a chronic, relapsing, and remitting course are uncommon, but can herald a diagnosis of high morbidity and mortality in the older population. Our method was a retrospective case series study. A review of clinical records of 782 patients ≥50 years of age diagnosed with recurrent sixth nerve palsies was performed over a 10-year period from 1995-2005 in a neuro-ophthalmology clinic in Reno, Nevada. A review of the current literature regarding similar cases was also performed on PubMed. Seven patients ≥50 years of age with chronic, recurrent sixth nerve palsies were identified. Five were males and two were females. Four of seven (57%) patients had structural lesions located in the parasellar or petrous apex cavernous sinus regions. One of seven (14.29%) had a recurrent painful ophthalmoplegic neuropathy (International Headache Society [IHS] 13.9), previously termed ophthalmoplegic migraine; one of seven (14.29%) presented with an intracavernous carotid artery aneurysm; and one of seven (14.29%) presented with microvascular disease. The clinical presentation of an isolated recurrent...Continue Reading

Citations

Nov 15, 2017·Optometry and Vision Science : Official Publication of the American Academy of Optometry·Crystal L DeLuca, Regina E Zimmers
Apr 8, 2020·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Sanskriti SasikumarFelix Tyndel
Mar 7, 2017·Frontiers in Neurology·Ségolène RoemerAki Kawasaki
Jun 16, 2018·Current Pain and Headache Reports·Stacy V Smith, Nathaniel M Schuster
Apr 13, 2019·BMJ Case Reports·Neha KhadeDavid Prentice
May 8, 2019·BMJ Case Reports·David MackinlayJaiganesh Manickavasagam
Sep 15, 2015·Current Opinion in Ophthalmology·Madhura A Tamhankar, Nicholas J Volpe
Jan 16, 2019·Neuro-ophthalmology·Korey A JabenDavid H Abramson

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