Aetiology of Acute Sixth Nerve Palsies in Children

Existing literature on the etiology of acute sixth cranial nerve palsies in children is variable with limited generalisablity given that many studies originate from tertiary Neuro-ophthalmic centres. An acute sixth nerve palsy may be the presenting feature of a brain tumour, but the spectrum of underlying etiology in children is wide including many more benign causes. Given the potential for serious underlying pathology, and as assessment of children with acute esotropia may be difficult, many proceed to neuroimaging often requiring general anaesthesia. We aimed to determine the incidence, underlying etiology and further management of acute sixth nerve palsy in our dedicated eye hospital.