A Prospective Study of the Causes and Magnetic Resonance Imaging Findings in Adult Isolated Non-traumatic Unilateral Abducens Palsy in Taiwan

Abstract

The objective of this study was to investigate the causes of acute isolated non-traumatic unilateral abducens palsy in adults and to evaluate the diagnostic relevance of Magnetic Resonance Imaging (MRI). This prospective study included a total of 40 patients presenting with acute isolated unilateral non-traumatic abducens palsy from January 2002 to June 2008 at Buddhst Tzu Chi General Hospital, Hualien. A standardized MRI protocol was performed within 1 week of the patient's first visit. In 23 patients (57.5%) a lesion was identified on the initial MRI relevant to the sixth nerve palsy. In 8 patients (20%) the cause was nasopharyngeal carcinoma. The MRI was positive in 4 out of 15 diabetic patients, and in 5 out of 12 patients with hypertension. MRI demonstrated the aetiology in 57.5% of cases of acute isolated non-traumatic unilateral abducens palsy, with nasopharyngeal carcinoma being a common cause in our study. We suggest a complete MRI study of the brain and the orbits, with axial, coronal and sagittal imaging, the use of intravenous contrast, and fat suppression techniques in acute adult isolated non-traumatic unilateral abducens palsy. etiology. 1-3 Bendszus et al. recommended that MRI should routinely be performed in patients presenting with acute sixth nerve palsy, while others suggested a medical evaluation and observation without initial neuroimaging in isolated presumed vasculopathic sixth nerve palsy. 4-7 The aims of this study were to investigate the causes of acute isolated nontraumatic unilateral abducens palsy in adults and to evaluate the diagnostic relevance of MRI. 174Neuroophthalmology Downloaded from informahealthcare.com by Michigan University on 11/04/14For personal use only.

The Urgency of Neuroimaging Among UK Neuro-Ophthalmologists: Consensus and Disagreement

“…This lack of agreement mirrors the conflicting conclusions of several series of ocular motor mononeuropathies in the recent literature. [9][10][11][12][13] Variant conclusions are not unexpected in these series due to their differing designs, study populations and imaging protocols. The only area of agreement in this section of the survey was for the case of a longstanding, decompensated, congenital IV nerve palsy where consensus was achieved that imaging was not normally performed.…”