abducens nerve


Summary: The 6th cranial nerve which originates in the ABDUCENS NUCLEUS of the PONS and sends motor fibers to the lateral rectus muscles of the EYE. Damage to the nerve or its nucleus disrupts horizontal eye movement control.

Top Publications

  1. Tatsumoto M, Odaka M, Hirata K, Yuki N. Isolated abducens nerve palsy as a regional variant of Guillain-Barré syndrome. J Neurol Sci. 2006;243:35-8 pubmed
    The authors reviewed clinical profiles and laboratory findings for 100 cases of abducens nerve paresis without impairment of the other cranial nerves, limb weakness, and ataxia throughout the clinical course...
  2. Kurihara T. Abducens nerve palsy and ipsilateral incomplete Horner syndrome: a significant sign of locating the lesion in the posterior cavernous sinus. Intern Med. 2006;45:993-4 pubmed
  3. Miyake N, Chilton J, Psatha M, Cheng L, Andrews C, Chan W, et al. Human CHN1 mutations hyperactivate alpha2-chimaerin and cause Duane's retraction syndrome. Science. 2008;321:839-43 pubmed publisher
    ..We conclude that alpha2-chimaerin has a critical developmental function in ocular motor axon pathfinding. ..
  4. Ozveren M, Uchida K, Erol F, Tiftikci M, Cobanoglu B, Kawase T. Isolated abducens nerve paresis associated with incomplete Horner's syndrome caused by petrous apex fracture--case report and anatomical study. Neurol Med Chir (Tokyo). 2001;41:494-8 pubmed
    ..Neurological examination revealed abducens nerve paresis, ptosis, and myosis on the right side...
  5. Moon K, Jung S, Lee K, Lee M. Cavernous hemangioma of the abducens nerve: clinical implication of duplicated variants: case report. Neurosurgery. 2011;69:E756-60; discussion E760 pubmed publisher
    A cavernous hemangioma arising from the abducens nerve has not been previously reported in the literature...
  6. Pizzolorusso F, Cirotti A, Pizzolorusso G. Anatomic variation of the abducens nerve in a single cadaver dissection: the "petrobasilar canal". Acta Neurochir (Wien). 2017;159:677-680 pubmed publisher
    Anatomic variations of the petrosphenoid ligament, Dorello's canal and the course of the abducens nerve have been extensively described over the past years...
  7. Colby G, Coon A, Connolly E, Ambron R. Activation of c-Jun and ATF-2 in primate motor cranial nerve nuclei is not associated with apoptosis following axotomy. Exp Neurol. 2005;194:57-65 pubmed
    ..This report serves as a basic inquiry into the neuronal response to cranial nerve injury in primates...
  8. Ren H, Cheng F, Qiu C. [Clinical observation on Chinese drug acupoint-injection for treatment of acquired abducent paralysis]. Zhongguo Zhen Jiu. 2008;28:41-3 pubmed
    ..05). Chinese drug acupoint-injection therapy has a definite therapeutic effect on acquired abducent paralysis, which is better than that of routine western medicine. ..
  9. Kayayurt K, Gündogdu Ã, YavaÅŸi Ã, Metin Y, Ugras E. Isolated abducens nerve palsy due to pituitary apoplexy after mild head trauma. Am J Emerg Med. 2015;33:1539.e3-4 pubmed publisher
    ..While the most commonly affected nerve is the oculomotor nerve, abducens nerve palsy may also occur less commonly...

More Information


  1. Radzišauskienė D, Ambrozaitis A, Marciuškienė E. Delayed diagnosis of lyme neuroborreliosis presenting with abducens neuropathy without intrathecal synthesis of Borrelia antibodies. Medicina (Kaunas). 2013;49:89-94 pubmed
    ..Surprisingly, Borrelia burgdorferi antibodies were not detected in the cerebrospinal fluid. ..
  2. Kim J, Hwang J. Abducens nerve is present in patients with type 2 Duane's retraction syndrome. Ophthalmology. 2012;119:403-6 pubmed publisher
    To determine whether the abducens nerve is present in patients with type 2 Duane's retraction syndrome (DRS). Retrospective, observational case series. Twelve consecutive patients diagnosed with type 2 DRS...
  3. Okanobu H, Kono R, Miyake K, Ohtsuki H. Splitting of the extraocular horizontal rectus muscle in congenital cranial dysinnervation disorders. Am J Ophthalmol. 2009;147:550-556.e1 pubmed publisher
  4. Nguyen L, Baker R, Spencer R. Abducens internuclear and ascending tract of deiters inputs to medial rectus motoneurons in the cat oculomotor nucleus: synaptic organization. J Comp Neurol. 1999;405:141-59 pubmed
  5. Komatsu F, Komatsu M, Di Ieva A, Tschabitscher M. Endoscopic anatomy of persistent trigeminal artery: a cadaveric study. Minim Invasive Neurosurg. 2011;54:223-7 pubmed publisher
    ..These 3 endoscopic approaches provided a superb image of the PTA and contribute to the anatomical comprehension of PTA. Additionally, these approaches make us more familiar with an endoscopic view of PTA. ..
  6. Graf W, Spencer R, Baker H, Baker R. Vestibuloocular reflex of the adult flatfish. III. A species-specific reciprocal pattern of excitation and inhibition. J Neurophysiol. 2001;86:1376-88 pubmed
  7. Leigh R, Ramat S. Neuropharmacologic aspects of the ocular motor system and the treatment of abnormal eye movements. Curr Opin Neurol. 1999;12:21-7 pubmed
    ..Finally, the results of basic neuropharmacologic studies have been used to identify candidate drugs for therapeutic trials of abnormal eye movements. ..
  8. Ozveren M, Erol F, Alkan A, Kocak A, Onal C, Ture U. Microanatomical architecture of Dorello's canal and its clinical implications. Neurosurgery. 2007;60:ONS1-7; discussion ONS7-8 pubmed
    We investigated the membranous architecture of the abducens nerve at the petroclival region and describe the characteristics of this area in cadaveric specimen and two children with hydrocephalus and sixth nerve palsy using magnetic ..
  9. Liu J. Dr. Zhang Ren's experience in acupuncture treatment of obstinate eye diseases. J Tradit Chin Med. 2006;26:42-6 pubmed
  10. Arasho B. Ophthalmoplegic migraine in a 15-year-old Ethiopian: case report and literature review. J Headache Pain. 2009;10:45-9 pubmed publisher
    ..The subsequent discussion focuses on current evidences with regard to the clinical characteristics, possible pathogenetic mechanisms and treatment. Finally, a brief discussion of the situation in Africa will be presented. ..
  11. Christoff A. Sensorimotor Characteristics of Neuro-Ophthalmology and Oculo-Plastics Patients. Am Orthopt J. 2015;65:47-57 pubmed publisher
    ..Trochlear nerve palsy (CN4) was more often associated with hydrocephalus than abducens nerve palsy (CN6), and trauma remained a common association with acquired CN4 palsy...
  12. Armenia J, Sigal M. Abducens paralysis repaired with muscle transposition and intraoperative botulinum toxin. Ann Ophthalmol. 1987;19:416-8, 422 pubmed
    ..Using this approach, fusion in down-gaze without correction and in the primary position with a small amount of vertical and horizontal prism correction was achieved. Good to excellent abduction was restored. ..
  13. Gonzalez Forero D, de la Cruz R, Delgado García J, Alvarez F, Pastor A. Correlation between CGRP immunoreactivity and firing activity in cat abducens motoneurons. J Comp Neurol. 2002;451:201-12 pubmed
    ..87 or higher. Therefore, CGRP expression and firing activity in abducens motoneurons are positively correlated. ..
  14. Keifer J, Clark T. Abducens conditioning in in vitro turtle brain stem without cerebellum requires NMDA receptors and involves upregulation of GluR4-containing AMPA receptors. Exp Brain Res. 2003;151:405-10 pubmed
    ..be induced in the presence of the NMDA receptor antagonist dl-2-amino-5-phosphonovaleric acid (AP-5) and that abducens nerve conditioned responses, once initiated in normal saline, were significantly attenuated in the presence of AP-5...
  15. Wu X. [Botulinum toxin A in treatment of the sixth cranial nerve palsy]. Zhonghua Yan Ke Za Zhi. 2002;38:457-61 pubmed
  16. Sato Y, Mizutani T, Shimizu K, Freund H, Samii M. Retrosigmoid Intradural Suprameatal-Inframeatal Approach for Complete Surgical Removal of a Giant Recurrent Vestibular Schwannoma with Severe Petrous Bone Involvement: Technical Case Report. World Neurosurg. 2018;110:93-98 pubmed publisher
    ..and hearing loss due to tumor invasion and previous operations, as well as left-sided trigeminal hypesthesia, abducens nerve palsy, and lower cranial nerve dysfunction due to tumor compression...
  17. Kunz M, Dorn F, Greve T, Stoecklein V, Tonn J, Bruckmann H, et al. Long-Term Functional Outcome of Symptomatic Unruptured Intracranial Aneurysms in an Interdisciplinary Treatment Concept. World Neurosurg. 2017;105:849-856 pubmed publisher
    ..002). Optic nerve compression symptoms were less likely to improve compared with abducens nerve palsies and brainstem compression...
  18. Easwer H, Chatterjee N, Thomas A, Santhosh K, Raman K, Sridhar R. Usefulness of flat detector CT (FD-CT) with biplane fluoroscopy for complication avoidance during radiofrequency thermal rhizotomy for trigeminal neuralgia. J Neurointerv Surg. 2016;8:830-3 pubmed publisher
    ..Two patients each had loss of corneal reflex and abducens nerve palsy after the procedure. No other complications were seen...
  19. Buttner Ennever J, Horn A, Scherberger H, d Ascanio P. Motoneurons of twitch and nontwitch extraocular muscle fibers in the abducens, trochlear, and oculomotor nuclei of monkeys. J Comp Neurol. 2001;438:318-35 pubmed
    ..The role of MIFs in eye movements is unclear, but the concept of a final common pathway must now be reconsidered. ..
  20. Keifer J, Mokin M. Distribution of anterogradely labeled trigeminal and auditory nerve boutons on abducens motor neurons in turtles: implications for in vitro classical conditioning. J Comp Neurol. 2004;471:144-52 pubmed
    A conditioned abducens nerve response is generated in in vitro brainstem preparations from turtles by pairing a weak conditioned stimulus (CS) applied to the auditory nerve that immediately precedes an unconditioned stimulus (US) applied ..
  21. Di Maio L, Marcelli V, Vitale C, Menzione M, De Giorgio A, Briganti F, et al. Cervico-oculo-Acoustic syndrome in a male with consanguineous parents. Can J Neurol Sci. 2006;33:237-9 pubmed
    ..Neurophysiological investigations revealed lower brainstem and cervical cord involvement. ..
  22. Kim J, Hwang J. Adduction on attempted abduction: the opposite of synergistic divergence. Arch Ophthalmol. 2006;124:918-20 pubmed
  23. Miyashita N, Hikosaka O. Minimal synaptic delay in the saccadic output pathway of the superior colliculus studied in awake monkey. Exp Brain Res. 1996;112:187-96 pubmed
    ..2 +/- 0.8 ms (SD; contralateral eye) for abducens nucleus stimulation. The time difference between SC- and BN-evoked eye movements (about 3 ms) was consistent with a disynaptic connection from the SC to the premotor BNs. ..
  24. Kyung S, Jeon J. Bupivacaine injection to lateral rectus in abducens nerve palsy. Korean J Ophthalmol. 2013;27:304-7 pubmed publisher
    A 49-year-old female presented with bilateral abducens nerve palsies. She had 75 prism diopter esotropia. The extraocular movement of the lateral rectus was -1 limitation for the right eye and -4 limitations for the left...
  25. Crouch E, Murray A, Madigan W. Management of a case of simultaneous abduction. J Pediatr Ophthalmol Strabismus. 2008;45:264-7 pubmed
  26. Vivo J, Morales J, Diz A, Galisteo A, Monterde J, Aguera E, et al. Structural and ultrastructural study of the intracranial portion of the oculomotor, trochlear and abducent nerves in dog. Anat Histol Embryol. 2006;35:184-9 pubmed
    ..27 microm and 0.47 +/- 0.09 in the abducent nerve respectively. This study reveals that oculomotor, trochlear and abducent nerves of the dog show structural and ultra-structural features similar to the same nerves in other species. ..
  27. Emiroglu M, Alkan G, Kartal A, Cimen D. Abducens nerve palsy in a girl with incomplete Kawasaki disease. Rheumatol Int. 2016;36:1181-3 pubmed publisher
    ..Cranial nerve palsies are seen rarely, and abducens nerve palsy has been reported in only three children. We describe a 2...
  28. Bernd P, Jakway J. A simplified approach to teaching medical students ocular movements and the rationale in testing the oculomotor, trochlear, and abducent nerves. Anat Sci Educ. 2008;1:126-9 pubmed publisher
    ..Inability to elevate or depress gaze from the abducted or adducted position shows which muscle, the oblique or rectus, and/or its innervation has been compromised. ..
  29. Fratello F, Veniero D, Curcio G, Ferrara M, Marzano C, Moroni F, et al. Modulation of corticospinal excitability by paired associative stimulation: reproducibility of effects and intraindividual reliability. Clin Neurophysiol. 2006;117:2667-74 pubmed
    ..Electrical stimulation of the median nerve followed by a magnetic pulse delivered on M1 after 25ms causes a reproducible increase in MEP amplitude, without showing an acceptable intraindividual reliability. ..
  30. Bodla A, Ablett M, Inglis A. Bilateral intracavernous carotid artery aneurysms presenting as progressive cranial nerve palsies. Clin Exp Optom. 2007;90:207-8 pubmed
    ..This case demonstrates the clinician's difficulty in diagnosis when isolated cranial nerve palsy is the sole presenting sign. ..
  31. Jiao Y, Zhao K, Wang Z, Qian X, Wu X, Man F. [Magnetic resonance imaging of the ocular motor nerves in normal volunteers]. Zhonghua Yan Ke Za Zhi. 2009;45:219-24 pubmed
    ..The capabilities of MRI can be fully used only with thorough knowledge of the complicated topographic relationships in the corresponding region. ..
  32. Liu D, Li C, Lee V. Internuclear ophthalmoplegia. Arch Neurol. 2006;63:626; author reply 626-7 pubmed
  33. Gonzalez Forero D, Alvarez F, de la Cruz R, Delgado García J, Pastor A. Influence of afferent synaptic innervation on the discharge variability of cat abducens motoneurones. J Physiol. 2002;541:283-99 pubmed
    ..It is concluded that abducens motoneurone spike variability during spontaneous ocular fixations depends largely on the balance between inhibitory and excitatory synaptic innervation. ..
  34. Broniarczyk Loba A, Omulecki W, Nowakowska O, Latecka Krajewska B. [Using a botuline toxin diagnostic test in a case of bilateral stilling--Türk--Duane (STD) syndrome found during preparation for cataract surgery]. Klin Oczna. 2004;106:666-9 pubmed
    ..This allows for further decisions of whether, and what type of surgical treatment should be performed. ..
  35. Xu Y, Simpson I, Tang X, Zhou W. Acoustic clicks activate both the canal and otolith vestibulo-ocular reflex pathways in behaving monkeys. J Assoc Res Otolaryngol. 2009;10:569-77 pubmed publisher
    ..These results provide new insights into the understanding of the neural basis for sound-evoked vestibular responses, which is essential for developing new tests for both canal and otolith functions in humans. ..
  36. Liu D, Chan A. Response to: 'Clinical characteristics of patients with ischemic ocular nerve palsies and lacunar brain infarcts--a retrospective comparative study'. Acta Neurol Scand. 2005;112:420; author response 421 pubmed
  37. Adam T, Schumacher M. Traumatic lesions of the optic, oculomotor, trochlear, and abducens nerves--computer tomographic findings. Neurosurg Rev. 1988;11:231-7 pubmed
    ..In 54 patients with functional disturbances of the optic, oculomotor, trochlear, or abducens nerve following severe multiple injuries, the initial computer tomographic examination was unable to document ..
  38. Morcuende S, Benitez Temino B, Pecero M, Pastor A, de la Cruz R. Abducens internuclear neurons depend on their target motoneurons for survival during early postnatal development. Exp Neurol. 2005;195:244-56 pubmed
    ..These results indicate that, during development, abducens internuclear neurons depend on their target motoneurons for survival, and that they lose this dependence with maturation. ..
  39. Hwang J, Seong M, Kim J, Park S. Absence of CHN1 in two patients with a bilateral absence of cranial nerves IV and VI. Graefes Arch Clin Exp Ophthalmol. 2015;253:491-2 pubmed publisher
  40. Wysiadecki G, Orkisz S, Gałązkiewicz Stolarczyk M, Brzezinski P, Polguj M, Topol M. The abducens nerve: its topography and anatomical variations in intracranial course with clinical commentary. Folia Morphol (Warsz). 2015;74:236-44 pubmed publisher
    The sixth cranial nerve (CN VI) - or the abducens nerve - in humans supplies only the lateral rectus muscle...
  41. Lemmerling M, De Praeter G, Mortele K, Vyt S, Vanzieleghem B, Coolens D, et al. Imaging of the normal pontine cisternal segment of the abducens nerve, using three-dimensional constructive interference in the steady state MRI. Neuroradiology. 1999;41:384-6 pubmed
    Our objective was to determine the visibility of the cisternal segment of the normal abducens nerve using a three-dimensional Fourier-Transform constructive interference in the steady state (3DFT-CISS) sequence...
  42. Oishi T, Sakai N, Sameshima T, Kawaji H, Namba H. The efficacy of resection of an intradural extramedullary foramen magnum cavernous malformation presenting with repeated subarachnoid hemorrhage: a case report. J Med Case Rep. 2017;11:63 pubmed publisher
    ..was a 70-year-old Japanese man who experienced a sudden onset of an occipital headache, followed by bilateral abducens nerve palsy...
  43. Kishimoto I, Shinohara S, Ueda T, Tani S, Yoshimura H, Imai Y. Orbital apex syndrome secondary to a fungal nasal septal abscess caused by Scedosporium apiospermum in a patient with uncontrolled diabetes: a case report. BMC Infect Dis. 2017;17:649 pubmed publisher
    ..The patient later complained of diplopia due to bilateral abducens nerve palsy, and was then referred to the department of Otolaryngology - Head and Neck Surgery, Kobe City Medical ..
  44. Barges Coll J, Fernandez Miranda J, Prevedello D, Gardner P, Morera V, Madhok R, et al. Avoiding injury to the abducens nerve during expanded endonasal endoscopic surgery: anatomic and clinical case studies. Neurosurgery. 2010;67:144-54; discussion 154 pubmed publisher
    ..We report an anatomoclinical study of the abducens nerve and describe relevant surgical nuances to avoid its injury...
  45. Kim J, Kim S, Hwang J. Combined bilateral absence of trochlear and abducens nerve. Neurol Sci. 2014;35:1457-9 pubmed publisher
  46. Kim J, Hwang J. Hypoplastic oculomotor nerve and absent abducens nerve in congenital fibrosis syndrome and synergistic divergence with magnetic resonance imaging. Ophthalmology. 2005;112:728-32 pubmed
    ..The aim of this report was to study the oculomotor nerve and the abducens nerve in 2 such patients with magnetic resonance imaging. Observational case reports...
  47. Iaconetta G, Fusco M, Samii M. The sphenopetroclival venous gulf: a microanatomical study. J Neurosurg. 2003;99:366-75 pubmed
    ..This conceptualization of the SPCVG is an attempt to define univocally the microanatomy of the sphenopetroclival region in its entirety. ..
  48. Zhang Y, Yu H, Shen B, Zhong C, Liu E, Lin Y, et al. Microsurgical anatomy of the abducens nerve. Surg Radiol Anat. 2012;34:3-14 pubmed publisher
    To clarify the oriented classification, relationships, and variations of the abducens nerve and provide a detailed description of its microsurgical anatomic features...
  49. Li Z, Li M, Liang J, Bao Y, Chen G, Guo H, et al. Usefulness of intraoperative electromyographic monitoring of oculomotor and abducens nerves during skull base surgery. Acta Neurochir (Wien). 2017;159:1925-1937 pubmed publisher
    ..We performed oculomotor nerve (CN III) and abducens nerve (CN VI) intraoperative monitoring in patients with skull base surgery by recording the spontaneous muscle ..
  50. Albayrak H, Tarakci N, Altunhan H, Ors R, Caksen H. A congenital cranial dysinnervation disorder: Möbius' syndrome. Turk Pediatri Ars. 2017;52:165-168 pubmed publisher
    ..Möbius' sequence, is a nonprogressive cranial dysinnervation disorder characterized by congenital facial and abducens nerve paralysis...
  51. Parsa C, Robert M. Thromboembolism and congenital malformations: from Duane syndrome to thalidomide embryopathy. JAMA Ophthalmol. 2013;131:439-47 pubmed
    ..Such malformations will occur more frequently under thrombogenic conditions, such as those induced by thalidomide. Fibrin emboli and focal hypoperfusion may explain the development of many sporadic congenital malformations. ..
  52. Miyake N, Demer J, Shaaban S, Andrews C, Chan W, Christiansen S, et al. Expansion of the CHN1 strabismus phenotype. Invest Ophthalmol Vis Sci. 2011;52:6321-8 pubmed publisher
    ..Analysis of the current pedigree expands the phenotypic spectrum of hyperactivating CHN1 mutations to include vertical strabismus and supraduction deficits in the absence of Duane retraction syndrome. ..
  53. Ozer E, Icke C, Arda N. Microanatomical study of the intracranial abducens nerve: clinical interest and surgical perspective. Turk Neurosurg. 2010;20:449-56 pubmed publisher
    The microanatomy of the abducens nerve (AN) is important for clinical reasons and surgical approaches as it is located in the petroclival region...