Clinical Profile of Sixth Nerve Palsy

Aim:This study aimed to assess various causative factors of sixth nerve palsy, the recovery rate of sixth nerve palsy, and to develop the diagnostic algorithm for sixth nerve palsy.Methods:This was a hospital-based retrospective observational study. For this study, electronic case records of all patients with sixth cranial nerve palsy who were followed up for 6 months were collected. The study duration was between June 2017 and May 2022. Characteristics such as the age of onset, gender, presence of any systemic conditions, and laterality were analysed.Results:Total number of patients was 82. 63% were males and rest were 37% females. 62% had systemic involvement, and 38% had no systemic involvement. Among systemic illnesses, diabetes was the most common cause of isolated sixth nerve palsy (61%). The most common cause of sixth nerve palsy was due to vasculopathy (49%). Trauma (11%) was the second leading cause of sixth nerve palsy; the tumour was very rare in our study about 1%. Sixth nerve palsy in idiopathic intracranial hypertension amounting to about 5%. We were unable to identify the cause in certain patients (16%); post-viral aetiology consists of about 1%, cortical vein thrombosis to about 1%, cavernous vein thrombosis to about 2%, aneurysm consists about 3%, congenital cause amounting to about 5%, inflammatory accounts about 6%. Recovery rate among sixth nerve palsy: 87% had complete recovery in our study; vasculopathy had a 100% recovery rate. In contrast, trauma had 50% recovery and 50% non-recovery rate. In contrast, tumour and congenital had no recovery rate.Conclusion:Ischaemia followed by trauma is the common aetiology raising concerns about the health issues of young Indians and road safety.