Abducens nerve enhancement demonstrated by multiplanar reconstruction of contrast-enhanced three-dimensional MRI

We describe contrast enhancement of the cisternal portion of the abducens n erve and discuss its clinical significance. We examined 67 patients with op hthalmoplegia using contrast-enhanced 3-dimensional (3D) MRI with multiplan ar reconstruction along the nerves and found 16 patients (ten men, six wome n), aged 10-73 years (mean 34.4 years), with contrast enhancement of the ab ducens nerve. Of the 36 patients who had an abducens palsy, 14 (39 %) showe d contrast enhancement. In the 16 patients, 23 abducens nerves enhanced; 13 were symptomatic and 10 asymptomatic at the time. The causes were dissemin ated tumour (1), an inflammatory process (3), trauma (2), ischaemia (2) and autoimmune diseases (8), such as the Miller Fisher syndrome, acute ophthal moparesis, polyneuropathy and multiple sclerosis. Abducens and/or oculomoto r nerve enhancement was the only abnormality on MRI in the patients with tr aumatic or ischaemic neuropathy or autoimmune diseases. There were 14 patie nts who recovered fully within 1-6 months after treatment, and resolution o f the enhancement correlated well with recovery.