What is included in the physical exam for abducens nerve palsy (sixth cranial nerve palsy)?

Updated: Nov 19, 2018
  • Author: Michael P Ehrenhaus, MD; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Answer

Examination for a sixth nerve palsy involves documenting the presence or absence of papilledema, examining the ocular motility, evaluating the eyelids and pupils, and excluding involvement of other cranial nerves (eg, V, VII, VIII).

Occasionally checking deep tendon reflexes (DTRs) and motor function to exclude corticospinal tract involvement may be important. MRI is indicated for any brainstem findings to exclude pontine glioma in children (most have papilledema and nystagmus without other cranial nerve involvement) and in adults who show no improvement.


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