RT Journal Article SR Electronic T1 Sixth cranial nerve palsy following closed head injury in a child. JF Journal of Accident & Emergency Medicine JO Arch Emerg Med FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine SP 172 OP 175 DO 10.1136/emj.14.3.172 VO 14 IS 3 A1 G J Hollis YR 1997 UL http://emj.bmj.com/content/14/3/172.abstract AB A five year old female had an isolated abducens nerve palsy following closed head injury. There was no associated skull fracture, haematoma, or other cranial nerve injury. The significance, frequency, and differential diagnosis of traumatic sixth cranial nerve injury is discussed, particularly in paediatric patients. Management is symptomatic; occlusion with an eye pad may be used if diplopia is significant. In young children alternate day occlusion of each eye will help prevent amblyopia. Most cases improve within three months and many resolve by six months. Residual palsy at six months is likely to be permanent and surgical treatment may be needed.