Sixth nerve palsy + ipsilateral Horner’s Syndrome = Parkinson’s Syndrome

PurposeTo present five patients with VIth nerve palsy and ipsilateral Horner’s Syndrome (HS), as a result of cavernous sinus alteration.Study designConsecutive case series.Material and methodsFive patients presented abducens palsy with horizontal diplopia (3 in primary position and 2 in lateral gaze only) and ipsilateral HS.Apraclonidine 0.5% drops evidenced sympathetic denervation in all patients 40–60 min after instillation. All 5 cases had neuroimages (MRI in 3 cases, Computerized Tomography – CT in one case and Magnetic Resonance Angiography – MRA in one case) demonstrating cavernous sinus lesions; 2 meningiomas, 1 carotid-cavernous aneurism, 1 foreign body (bullet) and 1 squamous cell carcinoma.ConclusionLesions on the cavernous sinus need to be considered in cases of abducens nerve palsy and ipsilateral Horner’s Syndrome.