Last reviewed 01/2018

The aetiology of abducens nerve palsy depends on whether the sufferer is an adult or a child:

In adults the common causes are:

  • tumour - e.g. nerve is compressed on the sharp edge of the petrous temporal bone with raised intracranial pressure, but it may also be directly compressed by a tumour in the cerebellopontine angle. Raised intracranial pressure may result in bilateral palsy.
  • trauma - commonly affected in fractured base of skull
  • cerebrovascular accidents - e.g. Millard Guber syndrome
  • diabetes may cause mononeuritis complex - bilateral or unilateral palsy
  • Wernicke's encephalopathy - bilateral
  • idiopathic

Frequent causes in children:

  • following mastoid and middle ear infections
  • brain stem tumour
  • infective, e.g. suppurative middle ear disease causing unilateral trigeminal pain and VI nerve palsy
  • birth injury or trauma