Abducens Nerve Palsy as a Presenting Symptom of Multiple Sclerosis

Turk J Ophthalmol. 2022 Aug 25;52(4):291-294. doi: 10.4274/tjo.galenos.2022.13245.


Multiple sclerosis (MS) is a chronic disorder characterized by demyelination of the central nervous system. It often presents in women aged 18-35 with neurological symptoms such as visual loss, paresthesia, focal weakness, and ataxia. Demyelination in the brainstem can result in internuclear ophthalmoplegia causing binocular horizontal diplopia. Our report details a patient with horizontal diplopia from an isolated abducens (sixth) nerve palsy as the initial symptom of MS. While rare, this demonstrates the importance of including MS in the differential diagnosis for an isolated abducens nerve palsy, especially in younger patients with no known vascular risk factors.

Keywords: Abducens nerve palsy; demyelination; diplopia; multiple sclerosis.

MeSH terms

  • Abducens Nerve Diseases* / complications
  • Abducens Nerve Diseases* / etiology
  • Brain Stem
  • Diplopia / complications
  • Diplopia / etiology
  • Female
  • Humans
  • Multiple Sclerosis* / complications
  • Multiple Sclerosis* / diagnosis
  • Ocular Motility Disorders*