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Neuro-Ophthalmology pp 53–60Cite as

Neuroimaging for Isolated Sixth Nerve Cranial Neuropathy

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Abstract

An acute neurologically isolated sixth nerve palsy in an adult over age 50 with vasculopathic risk factors is most commonly due to microvascular ischemia. Traditionally, clinical recommendation has been to defer immediate neuroimaging in favor of “watchful waiting” anticipating spontaneous recovery of the ocular motor palsy, as imaging is usually unrevealing. However, this approach may result in a missed or delayed diagnosis of an alternative, potentially (or perceived) life threatening or treatable cause of sixth nerve palsy, such as a space occupying mass or infarction. This chapter reviews the causes of isolated sixth nerve palsy, current guidelines for diagnostic evaluation, and the studies on the yield of neuroimaging for this condition.

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Authors and Affiliations

  1. Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Jeffrey Ma & Nicholas J. Volpe

Authors
  1. Jeffrey Ma
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  2. Nicholas J. Volpe
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Corresponding author

Correspondence to Nicholas J. Volpe .

Editor information

Editors and Affiliations

  1. Weill Cornell Medicine, Blanton Eye Institute Houston Methodist Hospital, Houston, TX, USA

    Andrew G. Lee

  2. Metabolic Neurology, Institute of Metabolism and Systems Research College of Medical & Dental Sciences University of Birmingham, Birmingham, UK

    Alexandra J. Sinclair

  3. Houston Methodist Hospital, Blanton Eye Institute, Houston, TX, USA

    Ama Sadaka

  4. Houston Methodist Hospital, Blanton Eye Institute, Houston, TX, USA

    Shauna Berry

  5. Birmingham Neuro-Ophthalmology, University Hospital Birmingham, Birmingham, UK

    Susan P. Mollan

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Ma, J., Volpe, N.J. (2019). Neuroimaging for Isolated Sixth Nerve Cranial Neuropathy. In: Lee, A., Sinclair, A., Sadaka, A., Berry, S., Mollan, S. (eds) Neuro-Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-98455-1_5

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  • DOI: https://doi.org/10.1007/978-3-319-98455-1_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98454-4

  • Online ISBN: 978-3-319-98455-1

  • eBook Packages: MedicineMedicine (R0)

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