• Acute sixth nerve palsy in a young man, beware of the 'red herring'.

      O'Neill, E C; Connell, P P; Kadare, S; Tormey, P T; Ophthalmology Department, Waterford Regional Hospital, Waterford, Ireland., evelynoneill@yahoo.com (2012-02-01)
      BACKGROUND: Cranial nerve palsies has several etiologies including vascular insufficiency, neoplasm, trauma and inflammation. Isolated sixth nerve palsy is an extremely rare presenting feature of leukemia. AIM: We describe an unusual ocular presentation of a bilateral progressive sixth nerve palsy in a young male with a preceding head injury. CONCLUSION: Acquired sixth nerve palsies in young adults may be due to trauma but in the absence of a definitive history other systemic processes must be outruled. We describe a case of bilateral sixth nerve palsy in a patient with ALL with no obvious CNS involvement. Potential etiological mechanisms are discussed.