A 68-year-old lady presented with sudden onset painless binocular diplopia, which was worse with distance vision. She was diagnosed with an isolated right abducens nerve palsy which resolved fully after 2 months. Between 2014 and 2025, she experienced 11 similar episodes. Initial neuroimaging was reported as normal, and other causes, such as myasthenia, were ruled out. She was discussed at a multidisciplinary neuroradiology meeting where the compression of the abducens nerve by an aberrant anterior inferior cerebellar artery (AICA) was identified as the likely cause of these recurrent episodes.
Moran et al. (Fri,) studied this question.