Benign Vi Nerve Palsies in Children

The case histories of 12 patients who developed a VI nerve palsy after an apparently benign illness have been presented. The palsy developed in children of any age in 7 to 21 days after fever or upper respiratory illness and cleared, in all but one child, within 10 weeks. Two etiologic mechanisms are possible: otitis media and its complications, or neuritis after systemic viral illness. The most important conclusion is that this is a relatively benign entity which first presents with malignant implications. Recognition of this syndrome allows the clinician to cautiously defer complicated diagnostic studies, such as arteriogram and pneumoencephalogram, with the expectation of improvement in the VI nerve palsy.