Isolated sixth nerve palsy: An uncommon presenting sign of multiple sclerosis

Dai Barr, Mark J. Kupersmith, Roger Turbin, Swaraj Bose, Richard Roth

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39 Scopus citations


We describe three patients in whom an isolated sixth nerve palsy was the only clinical symptom or sign of multiple sclerosis (MS). Data were collected prospectively over 6 years on these three patients, who showed no other signs of brainstem dysfunction or prior symptoms; in addition. Retrospective analysis of all patients with MS and all patients with sixth nerve palsy referred to a neuro-ophthalmology service between 1982 and 1998 showed isolated sixth nerve palsy to be the presenting sign of MS in only 0.5 % of these patients. MS was the cause of isolated sixth nerve palsy in 0.8 % of all patients and in 1.6 % of those aged 18-50 years. Although it has been previously suggested that sixth nerve palsy is a not uncommon presenting sign of MS, our results suggest it is rare.

Original languageEnglish
Pages (from-to)701-704
Number of pages4
JournalJournal of Neurology
Issue number9
StatePublished - 2000
Externally publishedYes


  • Multiple sclerosis
  • Sixth nerve palsy


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