A Decade-Long Dance With Diplopia: Unraveling the Enigma of Recurrent 6th Nerve Palsy

Abstract:

Introduction and Importance:

Recurrent diplopia poses a diagnostic challenge, necessitating a thorough evaluation to elucidate its underlying etiology and guide its management. We present the case of a 39-year-old farmer with recurrent 6th nerve palsy for over a decade, highlighting the complexity and persistence of this condition.

Case Presentation:

A 39-year-old farmer presented with recurrent diplopia attributed to 6th nerve palsy, with eight episodes over 14 years. Despite systemic steroid treatment, the symptoms recurred every 12-18 months. Clinical examination revealed right eye abduction impairment;-, no other abnormalities were detected. Magnetic resonance imaging (MRI) indicated rhinosinusitis, and the results of the autoimmune antibody test were negative.

Clinical Discussion:

This case challenges conventional diagnostic approaches, underscoring the need for a comprehensive evaluation and tailored management strategies. Despite extensive investigations, the etiology remains elusive, emphasizing the complexity of recurrent diplopia.

Conclusion:

Continued monitoring and further investigation are warranted to unravel the enigma of recurrent diplopia in this unique case, highlighting the importance of individualized approaches to guide optimal management.