Benign Recurrent VI Nerve Palsy in Childhood

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Abstract
The case of a child with 6 documented episodes of benign recurrent unilateral VI nerve palsy between the ages of 2 1/2 mo. and 3 yr is presented. Despite the recognized self-limiting course of this disorder, its possible evolution into a comitant esotropia makes close follow-up mandatory. The practical aspects of management including maintenance occlusion therapy are stressed as well as the need for prompt surgical intervention once the acquired stabismus has stabilized. The etiology of benign VI nerve palsy of childhood may have the same immunological basis as other cases of p-infectious neuropathy. This isolated postinfective cranial mononeuropathy easily blends into the continuum of neurological involvement seen with the Landry-Guillian-Barre syndrome. With recovery from the initial episode, the abducens nerve may have become predisposed to recurrent inflammatory episodes and recurrent loss of function. Usually these recurrences are triggered by febrile illnesses of childhood.

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