Sixth nerve palsy is a problem with eye movement. It happens because of a problem with the sixth cranial nerve. In some cases, sixth nerve palsy is present at birth. It can also result from other problems that occur later on. In adults, stroke is one of the most common causes of sixth nerve palsy. The most common symptom is double vision.

Treatment of sixth nerve palsy depends on its cause. Treatments may include:

• Antibiotics, for sixth nerve palsy caused by a bacterial infection.
• Corticosteroids, for sixth nerve palsy caused by inflammation.
• Surgery or chemotherapy, for sixth nerve palsy caused by a tumor, hydrocephalus, or an aneurysm.

If a sixth nerve palsy is caused by high blood pressure, diabetes, or both, treatment of these conditions will reduce risk for future problems.

Sometimes there is no treatment available for the underlying cause.

Your doctor may want to wait several months before starting other treatment. Symptoms from sixth nerve palsy often go away on their own. Sixth nerve palsy after a viral illness often goes away in a few months. Symptoms after injury may also go away over several months. In cases of injury, symptoms are less likely to go away fully. Symptoms are likely to go away fully if you have isolated sixth nerve palsy.

If you still have symptoms 6 months or so later, your doctor may advise treatments, such as:

• Alternating an eye patch on each eye to treat double vision.
• Special prism glasses to help align the eye.
• Botulinum toxin to temporarily paralyze the muscle on the other side of the eye and help eye alignment.
• Surgery, if other treatment choices have not worked.

Contact your doctor if you have any sudden severe symptoms, such as vision loss or trouble moving an arm or a leg.