What is the role of MRI in the workup of 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

MRI is indicated for the following:

  • Patients younger than 55 years with no vasculopathic history
  • Associated pain or other neurologic abnormality [11]
  • History of cancer
  • Bilateral sixth nerve palsy
  • Papilledema
  • In the event no marked improvement is seen or other nerves become involved

An LP should be considered if MRI results are negative.

If a presumed microvascular ischemic sixth nerve palsy does not improve within 3-4 months or if other cranial nerves become involved, a full medical, neurologic, and imaging workup should be performed.


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