She was conscious and cooperating, and the results of her system examination were normal, except for the right abducens nerve
Associated symptoms of transient visual changes, pulsatile tinnitus, neck and back pain, nausea, vomiting, photo/ phonophobia, and findings of abducens nerve
palsy or papilledema--while nonspecific--should raise suspicion for elevated ICP and IIH, especially in women who are obese.
Once the fibers reach the cavernous sinus, they travel with the abducens nerve
before joining the ophthalmic division of the trigeminal nerve and entering the orbit with its nasociliary branch.
THE ISOLATED ABDUCENS NERVE
PALSY OCCURED AFTER POSTVIRAL INFECTION IN A DIABETIC PATIENT.
A probable diagnosis can be made if papilledema is not present but there abducens nerve
(2) OAS can lead to dysfunction of the ophthalmic branch of the trigeminal nerve (cranial nerve V1), oculomotor nerve (cranial nerve III), trochlear nerve (cranial nerve IV), abducens nerve
(cranial nerve VI), and optic nerve (cranial nerve II).
Yalnizoglu, "Acute abducens nerve
paralysis in the Pediatric Emergency Department: Analysis of 14 patients," Pediatric Emergency Care, vol.
Neurologic presentation of meningoencephalitis with RP varied between cases; reported presentations were hearing loss, unsteadiness, personality changes, generalized tonic-clonic seizure, impaired cognitive function, impaired visual acuity, confusion, memory loss, unstable gait, ataxia, hydrocephalus, delirium, cerebral infarction, coordination problems, distraction, word finding difficulty, emotional lability, abducens nerve
palsy, anxiety, insomnia, memory loss, deafness, gait change, urinary incontinence, expressive and receptive aphasia, dullness, acalculia, and papilledema .
Oculomotor, trochlear, trigeminal, abducens, facial, and vestibulocochlear nerve palsies are well-recognised complications with the abducens nerve
being the most commonly affected one.
The classic Gradenigo syndrome triad is completed with the addition of diplopia due to involvement of the abducens nerve
in the Dorello canal in the petroclival region and deafness due to concurrent suppurative otitis media (2, 21).
Gradenigo's syndrome is characterised by a classic triad of discharging ear, retro-orbital pain, abducens nerve
paralysis causing diplopia.
Orbital apex syndrome (OAS) has been described as a syndrome involving damage to the oculomotor nerve (CN3), trochlear nerve (CN4), ophthalmic branch of the trigeminal nerve (CN5) and abducens nerve
(CN6) in association with optic nerve dysfunction.