Isolated sixth nerve palsy: a rare first presentation in multiple sclerosis

Qi Xun Lim (Lead / Corresponding author), Fahid Ahmed, Sirjhun Patel

Research output: Contribution to journalArticlepeer-review


True isolated sixth nerve palsy as the initial presentation of multiple sclerosis (MS) is rare. MS is a chronic inflammatory, immune-mediated disease of the central nervous system. This is the most common cause of neurological disability in young adults. Common symptoms include acute episodes of muscle weakness, altered sensation, balance and gait disturbances, visual loss and bladder dysfunction.Diagnosis of MS is supported with the incidence of symptomatic clinical episodes with subsequent cross-sectional imaging to confirm radiological lesions that are disseminated in space and time.In the following report, we discuss the case of a woman in her 30s who presented to ophthalmology with a sixth nerve palsy in the absence of ocular or systemic disease. This is the first presentation of MS, a rare clinical event.

Original languageEnglish
Article numbere247928
Number of pages5
JournalBMJ Case Reports
Issue number5
Early online date11 May 2022
Publication statusPublished - May 2022


  • Abducens Nerve Diseases/diagnosis
  • Female
  • Humans
  • Multiple Sclerosis/complications
  • Vision Disorders/complications
  • Young Adult
  • Multiple sclerosis
  • Visual pathway
  • Cranial nerves
  • Radiology
  • Ophthalmology

ASJC Scopus subject areas

  • General Medicine


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