Posttraumatic bilateral abducens nerves injury – case report

Correspondence to: Klinika Neurologii i Epileptologii II Katedry Chorób Układu Nerwowego Uniwersytetu Medycznego w Łodzi, USK nr 2 im. WAM, ul. Żeromskiego 113, 90-549 Łódź, tel./faks: 042 63 93 591

AKTUALN NEUROL 2006, 6 (3), p. 181-184

Oculomotor nerves (III, IV, VI) paralysis after cranial injury is not an exceptional case. However, bilateral abducens nerves injury following cranial trauma without fracture is a very rare occurrence. The abducens nerve (n. VI) is relatively long in its intracranial passage, during injury has relatively high elasticity and its mechanical avulsion is more difficult. In literature, we did not find any case describing bilateral abducens nerve injury as the only symptom of head trauma. There were described cases of unilateral injury of these nerves as an isolated symptom or in combination with the damage of other cerebral nerves mainly third and facial nerve. The authors present a case of a 67-year old man, in whom only bilateral abducens nerves injury was detected after cranial trauma. Neuroimaging examinations did not reveal the location of the injury. Lack of improvement of abducens nerves function in 4-month follow-up indicates, that most probably there came to neurotmesis as a result of injury. The authors consider the possible cause of VI nerve injury basing on various cases mentioned in literature.

Keywords: abducens nerve, third nerve palsy, head injury, bilateral abducens nerves injury, oculomotor palsy