Isolated bilateral abducens palsy is a rare event, especially in the setting of closed head injury. Cases that lack radiographic or pathologic findings to explain the etiology of the palsy are limited to case reports. Injury mechanisms have been postulated, but a consensus does not exist. The authors describe a case of traumatic isolated bilateral abducens palsy lacking radiographic and pathologic findings. A previously unreported potential pathophysiologic injury mechanism is theorized based upon anatomical structure and mode of injury.
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