Isolated sixth nerve palsy from pontine infarct.

Isolated sixth nerve palsy associated with pontine infarct is very rare due to close anatomic organization of the structures. A 62-year-old woman, who complained of diplopia, had a diagnosis of sixth nerve palsy. Ophthalmological examination revealed 30 PD left esotropia in primary position with limited abduction of the left eye. Neurologic examination was normal. MR showed a lacunar infarct in the pons consistent with a fascicular lesion. Cerebral angiography was normal. Pontine infarcts causing fascicular lesions should be kept in mind in isolated sixth nerve palsies.