Cranial Nerve 6 Palsy and MRI

[S__]

This is a follow-up on the question that I posted yesterday. My 15 month old just went to see her opthamologist (who is refering her to another opthamologist), and she was able to rule out any problems with her optic nerve, but she does want her to get checked for CN6 Palsy. This requires an MRI, and because of her age, she would have to be under general anaesthesia. I really do not like the sound of that. I was wondering if it is imperative that she get the MRI, or if it would be something that is just for a diagnosis, and it won't hurt her to not have it, or at least put it off for a couple of years. If the condition is indeed CN6 Palsy, is that something that will get worse or pose a serious medical problem for her? I really do not want her to face the risks of the anaesthesia, but I don't want to risk her other health, either.
Thank You.

[Michael J Kutryb, MD]

It's your call.  I would suggest you look very closely at the risk of Gadolinium dye which they sometimes use.  Please do some research on and very carefully way the risks of this dye - this is very important.  I personally would not allow the Gadolinium.  I am not so worried about the anesthesia or the MRI itself.  It may be the only way to identify a serious condition.  You don't really want to stay in the dark wondering what might be going on.

Michael Kutryb, MD

[S__]

Thank you! I will do some research about the dye, but I can tell you right now, I won't let them use it, based on what you've said, alone. The anesthesia still scares me, but if it is the only way to rule out something serious, I may have to let them do it.
Another question, if I may: We were told to do alternate patching until her next appointment (early next week). Would this be the treatment if she does indeed have CN6 Palsy? Or is it a very serious condition that will require a lot of medical attention?

[Michael J Kutryb, MD]

CN6 palsy will not respond to patching - but it is very rare at this age.  Treatment for something like that in an infant is beyond my training.

MJK MD

[S__]

It looks like we are going forward with the MRI. She will also see a pediatric specialist, next week. Thank you for your help!