A Rare Case of Concomitant Abducens and Contralateral Lower Motor Neuron Facial Nerve Palsies Following Blunt Head Trauma Associated With Temporal Bone Fracture

Abstract

This case report describes a case of concomitant abducens and contralateral lower motor neuron facial nerve palsies following blunt head trauma associated with left temporal bone fracture. A 11year old boy was brought to the emergency department with alleged history of fall from swing set. Detailed ocular examination and assessment of function of all the twelve cranial nerves of the patient revealed left oculomotor nerve paresis, left abducens nerve palsy and right sided lower motor neuron (LMN) facial nerve palsy. The patient was run through various neuroimaging investigations which showed longitudinal fracture of the left temporal bone. The patient was treated aggressively with systemic and oral steroids. On discharge, the left oculomotor nerve paresis had healed completely with no improvement in the other two affected cranial nerves. During one month follow up, the abducens and facial nerve palsies still persisted.