Isolated sixth cranial nerve palsy as the first manifestation of preeclampsia with twin pregnancy-case report and review of literature

Sixth cranial nerve palsy can occur either during or after gestation, and is often associated with hypertensive disorders of pregnancy. We report a case of a 39-year-old hypertensive primigravida with a twin pregnancy, who suddenly developed double vision in her second trimester. She was diagnosed t...

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Published inInternational Journal of Reproduction, Contraception, Obstetrics and Gynecology Vol. 14; no. 3; p. 971
Main Authors Ramnani, Vinita, Samadhiya, Richa, Mishra, Devanshi, Trivedi, Divya, Ramnani, Sakshi
Format Journal Article
LanguageEnglish
Published International Journal of Reproduction, Contraception, Obstetrics and Gynecology 01.03.2025
Subjects
Diagnosis
Enzymes
Hypertension
Preeclampsia
Pregnancy
Pregnant women
India
Online AccessGet full text
ISSN2320-1770
DOI10.18203/2320-1770.ijrcog20250545

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Summary:Sixth cranial nerve palsy can occur either during or after gestation, and is often associated with hypertensive disorders of pregnancy. We report a case of a 39-year-old hypertensive primigravida with a twin pregnancy, who suddenly developed double vision in her second trimester. She was diagnosed to have isolated sixth cranial nerve palsy in her left eye. Her anterior and posterior segment examination, as well neurological imaging, were found to be entirely within normal limits. She was subsequently admitted with severe pre-eclampsia and haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, and managed conservatively. The prognosis is usually favorable in such cases, with the palsy resolving as the blood pressure normalizes after delivery. This case demonstrates isolated abducens nerve palsy as the first sign of pre-eclampsia at 30 weeks of gestation. Keywords: Pre-eclampsia, Pregnancy, Hypertension, HELLP
ISSN:2320-1770
DOI:10.18203/2320-1770.ijrcog20250545