Sixth nerve palsy: Difference between revisions
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==Diagnostic Evaluation== | ==Diagnostic Evaluation== | ||
===Evaluation=== | |||
*Clinical exam | |||
*[[Neurologic exam|Complete neuro exam]] | |||
===Work-up=== | |||
*POC glucose | |||
*CBC | |||
*BMP | |||
*ESR | |||
*Lyme Titer | |||
*RPR | |||
*CT/MRI Brain | |||
==Management== | ==Management== | ||
Revision as of 14:38, 7 September 2015
Background
- Most common ocular nerve palsy
- Innervates the ipsilateral lateral rectus muscle controlling eye abduction
- Esotropia of the affected eye due to the unopposed action of the medial rectus muscle
Clinical Features
- Frequently present with diplopia and esotropia
- May have a head turn to help correct their diplopia
Differential Diagnosis
- Giant Cell Arteritis
- Medial Orbital Fracture (with entrapment of the medial rectus muscle)
- ocular Myasthenia Gravis
- Miller-Fisher Syndrome Guillian-Barre Syndrome
- Congenital Esotropia
- Meningitis
Diagnostic Evaluation
Evaluation
- Clinical exam
- Complete neuro exam
Work-up
- POC glucose
- CBC
- BMP
- ESR
- Lyme Titer
- RPR
- CT/MRI Brain
Management
Disposition
Dispo appropriate to etiology, consult either Neuro or Ophtho.