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6th Nerve Palsy
CN 6 injury causes failure of ipsilateral eye abduction. Permission from Dr. Schwartzman adapt/reuse photograph within this image.

6th Nerve Palsy

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The sixth nerve has a long intracranial course and is involved in many conditions that affect the base of the skull.
CN 6 injury causes failure of ipsilateral eye abduction.
CN 6 nuclear lesions can affect the initiation of movement of the opposite eye, as well - see the CN 6 nuclear lesion image for details.
Causes include:
  • Meningitis
  • Metastatic lesions and skull-based tumors
  • Intraparenchymal involvement occurs with pontine strokes (often in conjunction with a nuclear seventh nerve palsy), the Millard–Gubler syndrome, or with Locked-In Syndrome.
  • In isolation or with a contralateral hemiparesis it is Ramon’s syndrome.
  • It may be trapped unilaterally or bilaterally under the petroclinoid ligament (Dorello’s canal at the petrous apex) with acute increased intracranial pressure (a false localizing sign).