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April 1983

Benign Recurrent Sixth Nerve Palsies in ChildhoodSecondary to Immunization or Viral Illness

Author Affiliations

From the Neuro-ophthalmology Unit, Wills Eye Hospital, Philadelphia (Drs Savino and Schatz), and the Departments of Ophthalmology and Neurology, University of Pennsylvania, Philadelphia (Drs Savino and Schatz). Dr Werner is in private practice in State College, Pa.

Arch Ophthalmol. 1983;101(4):607-608. doi:10.1001/archopht.1983.01040010607016

• Four children had benign, isolated, and recurrent sixth nerve palsies. Two of the children had palsies that occurred following immunizations. This had not been previously reported, to our knowledge. The other two patients had palsies that followed mild, febrile illnesses that were assumed to be of viral origin. In all patients the palsy resolved without other associated neurologic signs or symptoms. When a child has an atraumatic sixth nerve palsy, a tumor, hydrocephalus, and meningitis must be considered. If the neurologic examination shows no associated abnormalities, invasive testing is not indicated. The patient should be followed up closely by the ophthalmologist and pediatrician for spontaneous recovery.