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Isolated Abducens Nerve Palsy Due to Anterolateral Pontomedullary Infarction in a Young Adult

Shao-Yin Chu a, Pao-Sheng Yen b, Yuan-Chieh Lee c, d, e

aDepartment of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
bDepartment of Radiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
cDepartment of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
dDepartment of Medicine and Graduate Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
eDepartment of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan

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Abstract

A 24-year-old woman suffered from headache for several days, and then binocular diplopia occurred. On examination, she demonstrated signs of right abducens nerve palsy. General examination was unremarkable. A detailed neurological examination was normal, revealing no evidence of brain stem dysfunction. Brain magnetic resonance imaging (MRI) demonstrated hyperintensities in the right upper anterolateral medulla on T2weighted images and diffusion-weighted images. Her diplopia resolved in 2 months. Ophthalmological examination revealed complete recovery. Follow-up MRI revealed hyperintensities in the right anterolateral lower pons and upper medulla. A complete MRI study should be considered in nontraumatic isolated abducens palsy, which includes thin sections through the nucleus and fascicle of the abducens nerve.


Keywords

Abducens palsy; Magnetic resonance imaging; Pontomedullary infarction


 

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