Isolated abducens nerve palsy

The more strokes you treat the less you remember the old wisdoms, such as IV and VI aren’t as bad as III. 

Presented a patient with isolated VI nerve palsy, what is the management? When could you forgo imaging?

  • Review the anatomy of VI, remarking how easy it is to harm, but nearly always requires concurrent symptoms of other areas (such as VII, sensory, paralysis, IV/III and so on)
  • do a proper exam to rule these symptoms out
  • if the clinical course and risk factors for microvascular damage are typical, you can do without imaging and observe.

References: This excellent article. 

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