Sixth Nerve Palsies

Commonest cause of neurogenic strabismus

Consider alternative diagnoses that can mimic

• Mechanical

  • Duane syndrome
  • Medial orbital wall fracture
  • Thyroid eye disease

• Myopathic:

  • Myasthenia
  • Myositis

• Convergence spasm

• Distance esotropia with high myopia

• Congenital esotropia with cross-fixation

Anatomy nuggets

• Nucleus lies in…