Case Report: Isolated Congenital Absence of Right Abducens Nerve in 4-Year-Old Child
This case report presents a 4-year-old male with isolated congenital absence of the right abducens nerve, resulting in right esotropia and limited eye movement. MRI findings confirmed the diagnosis, revealing the absence of the right abducens nerve while the left abducens nerve and other cranial nerves were normal. References to similar conditions are provided for context.
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Presentation Transcript
ISOLATED CONGENITAL ABSENCE OF THE RIGHT ABDUCENS NERVE IN 4-YEAR-OLD CHILD: A CASE REPORT. First Author : Sara Abdullah Mohammed Alamrani, Radiology specialist, Ministry of health Second Author : Balqees Khamees MasoadAlabri, Radiology Resident, Oman Medical Specialty Board Supervisor : Ahmed Khalfan Alduhli , Radiology consultant. Sultan Qaboos university Hospital
Case Presentation Patient Overview: 4-year-old male with inward deviation of the right eye since age 6 months. No history of trauma or systemic illnesses; normal prenatal and postnatal course. Normal developmental milestones; no neurological deficits. Clinical Findings: Right Esotropia (30 prism diopter). Limited Abduction in right eye. Normal pupil reactions; no ptosis, proptosis, or other abnormalities. MRI Findings MRI of the Brain: Key findings: Absent Right Abducens Nerve in its cisternal segment. Normal Left Abducens Nerve and other cranial nerves. No abnormal signal intensity or focal lesions. Midline structures and corpus callosum are unremarkable. Diagnosis: Congenital Absence of the Right Abducens Nerve confirmed.
Figure 1: Brain MRI examinations on axial plane, Steady-state free procession (SSFP), at the level of pons shows absent right abducens nerve in its cisternal segment. Left abducnce nerve is normal along it is course. The rest of cranial nerve was intact. Figure B, C: Axial T2WI and sagittal T1 shows no abnormal signal intensity. Corpus callosum and mid line structures are unremarkable.
REFERENCES: 1.Philips WH, Dirion JK, Graves GO. Congenital bilateral palsy of the abducens. Arch Ophthalmol. 1932;8:355-364. 2.Hickey WF, Wagoner MD. Bilateral congenital absence of the abducens nerve. Arch Neurol. 1983;40(6):367-369. PMID: 6419457. 3.Zaidi SMH, Tahir U. Moebius syndrome: what we know so far. Cureus. 2023;15(2):e35187. 4.Hotchkiss MG, Miller NR, Clark AW, Green WR. Bilateral Duane's syndrome: a clinical- pathological case report. Arch Ophthalmol. 1980;98(5):870-874.
