Elevated LP opening pressure > 250 mm [H.sub.2]O (adults); > 280 mm [H.sub.2]O (children); > 250 mm [H.sub.2]O if not sedated or obese (children) IIH without papilledema qualifies if criteria B-E are met and the patient also has unilateral or bilateral
abducens nerve palsy; or in the absence of papilledema and
abducens nerve palsy, an IIH diagnosis can be suggested if criteria B-E are met and 3 of the following neuroimaging criteria are satisfied: 1.
Clinical symptoms of the SOFS can be explained by the nerve involved, thus these symptoms may include some or all of the following: ophthalmoplegia, ptosis, proptosis, fixed and dilated pupils, anesthesia/paresthesia of forehead, hypolacrimation, diplopia, and decreased visual acuity.[10],[13],[14] External ophthalmoplegia occurs because of hypofunction of the oculomotor, trochlear, and
abducens nerves, which may also explain the resulting diplopia.[10],[11],[14]
Chen, "Isolated unilateral
abducens cranial nerve palsy: A rare presentation of pituitary apoplexy," European Journal of Ophthalmology, vol.
Yalnizoglu, "Acute
abducens nerve paralysis in the Pediatric Emergency Department: Analysis of 14 patients," Pediatric Emergency Care, vol.
One month later, his neurological symptoms had improved: (1) right oculomotor palsy with ptosis, (2) contralateral
abducens palsy with ocular nystagmus, (3) disturbance of bilateral suprainfraduction, (4) contralateral hemiparesis and ataxia, and (5) cognitive dysfunction and attentional deficit.
In 1907, Guisseppe Gradenigo described a symptom complex of suppurative otitis media, pain in the distribution of the trigeminal nerve, and
abducens (6th) nerve palsy [6].
Karatas et al., "
Abducens nerve palsy and optic neuritis as initial manifestation in brucellosis," Scandinavian Journal of Infectious Diseases, vol.
Bilateral
abducens palsies and facial weakness as initial manifestations of a Chiari 1 malformation.
(2) OAS can lead to dysfunction of the ophthalmic branch of the trigeminal nerve (cranial nerve V1), oculomotor nerve (cranial nerve III), trochlear nerve (cranial nerve IV),
abducens nerve (cranial nerve VI), and optic nerve (cranial nerve II).
Delgado-Garcia, "Effects of botulinum neurotoxin type A on
abducens motoneurons in the cat: ultrastructural and synaptic alterations," Neuroscience, vol.
###5.###Bilateral facial or
abducens weakness with distal paresthesias.
Detailed magnetic resonance imaging anatomy of the cisternal segment of the
abducens nerve: Dorello's canal and neurovascular relationships and landmarks.
The classic Gradenigo syndrome triad is completed with the addition of diplopia due to involvement of the
abducens nerve in the Dorello canal in the petroclival region and deafness due to concurrent suppurative otitis media (2, 21).
Orbital apex syndrome (OAS) has been described as a syndrome involving damage to the oculomotor nerve (CN3), trochlear nerve (CN4), ophthalmic branch of the trigeminal nerve (CN5) and
abducens nerve (CN6) in association with optic nerve dysfunction.
