Sixth nerve palsy is a problem with eye movement. It happens because of a problem with the sixth cranial nerve. In some cases, sixth nerve palsy is present at birth (congenital). It can also result from other problems that occur later on. These may include a viral infection, a head injury, a tumor, an infection, or inflammation. It may also happen because of an increase in intracranial pressure from conditions such as hydrocephalus. The most common symptom is double vision.
Types of treatment
Treatment of sixth nerve palsy depends on its cause. Treatments may include:
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Antibiotics, for sixth nerve palsy caused by bacterial infection
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Corticosteroids, for sixth nerve palsy caused by inflammation
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Surgery or chemotherapy, for sixth nerve palsy caused by a tumor or hydrocephalus
Sometimes, there is not a treatment available for the cause.
Your child’s healthcare provider may want to wait several months before starting more treatment. Depending on the cause, symptoms often go away on their own. Sixth nerve palsy after a viral illness often goes away in a few months. Symptoms after injury may also go away in a few months. In cases of injury, symptoms are less likely to go away fully. Symptoms are likely to go away fully if your child has isolated sixth nerve palsy.
If your child still has symptoms 6 months or so later, your child’s healthcare provider may advise treatments, such as:
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Alternate an eye patch on each eye to treat double vision
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Special prism glasses to help align the eye
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Botulinum toxin to temporarily paralyze the muscle on the other side of the eye and help eye alignment
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Surgery, if other treatment choices have not worked
When to call your child's healthcare provider
Call the healthcare provider if your child has any sudden severe symptoms. These may include vision loss or trouble moving an arm or a leg.