Chronic sixth nerve palsies. Are they really harbingers of serious intracranial disease?

Abducens palsies are encountered frequently in ophthalmologic practice and are usually benign transient deficits. When a sixth nerve palsy lasts longer than three months, conventional wisdom dictates an extensive investigation. In this report, we describe 38 patients with chronic, isolated sixth nerve palsies. The patient who is seen initially with an abducens palsy should undergo thorough medical and neurologic examinations to determine if the palsy is isolated. If it is isolated, the condition is not likely due to serious intracranial disease despite a duration of greater than three months.