Structure involved | Clinical presentation |
Nuclear lesions | |
Abducens nucleus | Horizontal gaze palsy |
Möbius syndrome (gaze palsy with facial diplegia) | |
Duane retraction syndrome (gaze palsy with globe retraction and narrowing of palpebral fissure with adduction) | |
Dorsolateral pons | Foville syndrome (ipsilateral gaze palsy, facial paresis, dysmetria occasionally with contralateral hemiparesis) |
Lesions of the abducens fascicle | |
Abducens fascicle | Isolated CN VI palsy |
Anterior paramedial pons | Ipsilateral CN VI palsy, ipsilateral CN VII palsy, contralateral hemiparesis (Millard-Gubler) |
Prepontine cistern | May have contralateral hemiparesis |
Lesion of abducens nerve (subarachnoid, petrous) | |
Petrous apex (Dorello canal) | CN VI palsy, deafness, facial (especially retroorbital) pain (Gradenigo) |
Cavernous sinus | |
Isolated CN VI palsy; CN VI palsy plus Horner syndrome; also may affect CN III, IV, V1 | |
Superior orbital fissure syndrome | |
CN VI palsy with variable affection of CN III, IV, V1; proptosis | |
Orbit | |
CN VI palsy; visual loss; variable proptosis, chemosis, lid swelling |
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