Anatomy and Function of Abducens Nerve

Table of ContentsView AllTable of ContentsLocationFunctionAnatomical VariationsAssociated ConditionsDiagnosisTreatment

Table of ContentsView All

View All

Table of Contents

Location

Function

Anatomical Variations

Associated Conditions

Diagnosis

Treatment

The function of the abducens nerve is to move your lateral rectus muscle. This lets your eye rotate away from the center of your body and look to the left or right.

Sometimes called the abducent nerve, the abducens nerve is the sixth cranial nerve (CN VI). This nerve has only a motor function and lacks a sensory function. Along with theoculomotor nerve(CN III) and thetrochlear nerve(CN IV), it provides movement to the muscles around the eyeball rather than attaching to the eye itself.

Humans have 12cranial nervesthat exist in generally symmetrical pairs, one on each side of your head. Unless it’s necessary to distinguish one side from the other (such as if one of them is damaged), each pair is most often referred to as a single nerve.

The abducens nerve emerges from the brainstem, which sits low in the back of your brain and connects to the spinal column. The specific area that this cranial nerve comes from is called the abducens nucleus. It then:

A small branch of the abducens nerve also connects to the contralateral medial rectus muscle. This allows for simultaneous side-to-side movement of your eyes.

Abducens nerve palsy symptoms cause the eye to droop inward as if “crossed.” This can result indiplopia(double vision), with eyes that aren’t looking in the same direction.Amblyopia(lazy eye) is common in children with abducens nerve damage.

The cranial nerves are different from the rest of your nerves, which originate in the spinal cord. Cranial nerves originate from the brain and brainstem and perform functions in your face and throat.

Since the abducens nerve connects to the lateral rectus muscle, it allows you to move your eyeballs toward the outside and away from your nose. It also helps your eyes to move together. The abducens nerve functions entirely as a motor nerve, key to mobility and motion rather than sensation.

When problems arise with the abducens nerve, other nerves often are involved.

Many nerves have known anatomical variations. These are important for healthcare providers to know so they can make an accurate diagnosis of a condition. It’s key information when planning surgery, in order to avoid damaging a nerve.

The abducens nerve has a few known variations. In some people, the nerve may:

The abducens nerve travels farther through the skull than any other cranial nerve. This leaves it vulnerable to injury at multiple points, although the point at which it enters the Dorello canal is a common injury site.Damage to this nerve is called abducens nerve palsy or sixth cranial nerve palsy.

Downward pressure on the brainstem is a common cause of abducens damage. Other causes include:

In people with diabetes, poorly controlled blood sugars are a significant risk factor for abducens nerve palsy, as are certain problems in the cavernous sinus. However,diabetic neuropathyand cavernous sinus problems are likely to affect many nerves beyond the abducens.

In a study of 54 adults, the abducens nerve was the most frequently damaged nerve of the eye, affected in 75.9% of people. Infection was the most common cause.The third and fourth cranial nerves are the most commonly injured in kids, typically for congenital (at birth) reasons, but trauma most often leads to abducens damage and idiopathic (unknown) reasons are common.

The diagnosis of abducens nerve damage involves the identification of the underlying cause. A person should see a specialist to evaluate for the underlying cause of the abducens nerve palsy.

Your healthcare provider may need to rule out a central cause like a brain mass or stroke or confirm an infection (common in cases involving diabetes).The cause may be congenital in kids, and management of abducens nerve palsy is different than it is for adults.

Treatment of the abducens nerve varies, depending on the cause and the person’s age.

In children, treatment focuses on training the eye to restore proper movement. This can be accomplished in several ways, including:

In adults, the first-line treatment for abducens nerve palsy is, most often, wait and see. Most cases resolve on their own. When that doesn’t happen, the treatment is determined based on what caused the palsy. Treatment may include:

Summary

The abducens nerve is a cranial nerve that enables eye motion so that you can see from the corner of your eye, and so that your eyes move together. It is the sixth cranial nerve. A number of health conditions or injuries can lead to damage, called abducens nerve palsy.

Infections are common, as is damage from interrupted blood flow. Some cases are present at birth, and both children and adults can be affected. Treatment options depend on the underlying cause, so contact your healthcare provider for an accurate diagnosis if you experience symptoms.

10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Radiopaedia.Abducens nerve.Priya S, Guha S, Mittal S, Sharma S, Alam MS.Pediatric ocular motor cranial nerve palsy: Demographics and etiological profile.Indian J Ophthalmol. 2021 May;69(5):1142-1148. doi:10.4103/ijo.IJO_1803_20Lucio LL, Freddi TAL, Ottaiano AC.The Abducens Nerve: Anatomy and Pathology.Semin Ultrasound CT MR. 2022 Oct;43(5):414-419. doi:10.1053/j.sult.2022.04.008Wang JMH, Edwards BA, Loukas M, Oskouian RJ, Tubbs RS.Supernumerary abducens nerves: a comprehensive review.World Neurosurg. 2018;112:39–45. doi:10.1016/j.wneu.2017.11.052Pizzolorusso F, Cirotti A, Pizzolorusso G.Anatomic variation of the abducens nerve in a single cadaver dissection: the “petrobasilar canal”.Acta Neurochir (Wien). 2017 Apr;159(4):677-680. doi:10.1007/s00701-017-3096-1Coquet T, Lefranc M, Chenin L, Foulon P, Havet É, Peltier J.Unilateral duplicated abducens nerve coursing through both the sphenopetroclival venous gulf and cavernous sinus: a case report.Surg Radiol Anat. 2018 Jul;40(7):835-840. doi:10.1007/s00276-018-2003-7Alkhatib RF, Chen RC, Sing BWH, Sanamandra SK.Unilateral abducens nerve avulsion injury following trauma.Singapore Med J. 2023 Nov 9. doi:10.4103/singaporemedj.SMJ-2022-222Cedars-Sinai.Sixth Nerve Palsy.Mehta MM, Garg RK, Rizvi I, Verma R, Goel MM, Malhotra HS,et al.The Multiple Cranial Nerve Palsies: A Prospective Observational Study.Neurol India. 2020 May-Jun;68(3):630-635. doi:10.4103/0028-3886.289003Ganesh S, Anilkumar SE, Narendran K.Botulinum toxin A in the early treatment of sixth nerve palsy in type 2 diabetes.Indian J Ophthalmol. 2019 Jul;67(7):1133-1136. doi:10.4103/ijo.IJO_1267_18Additional ReadingNam YS, Kim IB, Shin SY.Detailed anatomy of the abducens nerve in the lateral rectus muscle.Clin Anat. 2017;30(7):873–877. doi:10.1002/ca.22918

10 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Radiopaedia.Abducens nerve.Priya S, Guha S, Mittal S, Sharma S, Alam MS.Pediatric ocular motor cranial nerve palsy: Demographics and etiological profile.Indian J Ophthalmol. 2021 May;69(5):1142-1148. doi:10.4103/ijo.IJO_1803_20Lucio LL, Freddi TAL, Ottaiano AC.The Abducens Nerve: Anatomy and Pathology.Semin Ultrasound CT MR. 2022 Oct;43(5):414-419. doi:10.1053/j.sult.2022.04.008Wang JMH, Edwards BA, Loukas M, Oskouian RJ, Tubbs RS.Supernumerary abducens nerves: a comprehensive review.World Neurosurg. 2018;112:39–45. doi:10.1016/j.wneu.2017.11.052Pizzolorusso F, Cirotti A, Pizzolorusso G.Anatomic variation of the abducens nerve in a single cadaver dissection: the “petrobasilar canal”.Acta Neurochir (Wien). 2017 Apr;159(4):677-680. doi:10.1007/s00701-017-3096-1Coquet T, Lefranc M, Chenin L, Foulon P, Havet É, Peltier J.Unilateral duplicated abducens nerve coursing through both the sphenopetroclival venous gulf and cavernous sinus: a case report.Surg Radiol Anat. 2018 Jul;40(7):835-840. doi:10.1007/s00276-018-2003-7Alkhatib RF, Chen RC, Sing BWH, Sanamandra SK.Unilateral abducens nerve avulsion injury following trauma.Singapore Med J. 2023 Nov 9. doi:10.4103/singaporemedj.SMJ-2022-222Cedars-Sinai.Sixth Nerve Palsy.Mehta MM, Garg RK, Rizvi I, Verma R, Goel MM, Malhotra HS,et al.The Multiple Cranial Nerve Palsies: A Prospective Observational Study.Neurol India. 2020 May-Jun;68(3):630-635. doi:10.4103/0028-3886.289003Ganesh S, Anilkumar SE, Narendran K.Botulinum toxin A in the early treatment of sixth nerve palsy in type 2 diabetes.Indian J Ophthalmol. 2019 Jul;67(7):1133-1136. doi:10.4103/ijo.IJO_1267_18Additional ReadingNam YS, Kim IB, Shin SY.Detailed anatomy of the abducens nerve in the lateral rectus muscle.Clin Anat. 2017;30(7):873–877. doi:10.1002/ca.22918

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Radiopaedia.Abducens nerve.Priya S, Guha S, Mittal S, Sharma S, Alam MS.Pediatric ocular motor cranial nerve palsy: Demographics and etiological profile.Indian J Ophthalmol. 2021 May;69(5):1142-1148. doi:10.4103/ijo.IJO_1803_20Lucio LL, Freddi TAL, Ottaiano AC.The Abducens Nerve: Anatomy and Pathology.Semin Ultrasound CT MR. 2022 Oct;43(5):414-419. doi:10.1053/j.sult.2022.04.008Wang JMH, Edwards BA, Loukas M, Oskouian RJ, Tubbs RS.Supernumerary abducens nerves: a comprehensive review.World Neurosurg. 2018;112:39–45. doi:10.1016/j.wneu.2017.11.052Pizzolorusso F, Cirotti A, Pizzolorusso G.Anatomic variation of the abducens nerve in a single cadaver dissection: the “petrobasilar canal”.Acta Neurochir (Wien). 2017 Apr;159(4):677-680. doi:10.1007/s00701-017-3096-1Coquet T, Lefranc M, Chenin L, Foulon P, Havet É, Peltier J.Unilateral duplicated abducens nerve coursing through both the sphenopetroclival venous gulf and cavernous sinus: a case report.Surg Radiol Anat. 2018 Jul;40(7):835-840. doi:10.1007/s00276-018-2003-7Alkhatib RF, Chen RC, Sing BWH, Sanamandra SK.Unilateral abducens nerve avulsion injury following trauma.Singapore Med J. 2023 Nov 9. doi:10.4103/singaporemedj.SMJ-2022-222Cedars-Sinai.Sixth Nerve Palsy.Mehta MM, Garg RK, Rizvi I, Verma R, Goel MM, Malhotra HS,et al.The Multiple Cranial Nerve Palsies: A Prospective Observational Study.Neurol India. 2020 May-Jun;68(3):630-635. doi:10.4103/0028-3886.289003Ganesh S, Anilkumar SE, Narendran K.Botulinum toxin A in the early treatment of sixth nerve palsy in type 2 diabetes.Indian J Ophthalmol. 2019 Jul;67(7):1133-1136. doi:10.4103/ijo.IJO_1267_18

Radiopaedia.Abducens nerve.

Priya S, Guha S, Mittal S, Sharma S, Alam MS.Pediatric ocular motor cranial nerve palsy: Demographics and etiological profile.Indian J Ophthalmol. 2021 May;69(5):1142-1148. doi:10.4103/ijo.IJO_1803_20

Lucio LL, Freddi TAL, Ottaiano AC.The Abducens Nerve: Anatomy and Pathology.Semin Ultrasound CT MR. 2022 Oct;43(5):414-419. doi:10.1053/j.sult.2022.04.008

Wang JMH, Edwards BA, Loukas M, Oskouian RJ, Tubbs RS.Supernumerary abducens nerves: a comprehensive review.World Neurosurg. 2018;112:39–45. doi:10.1016/j.wneu.2017.11.052

Pizzolorusso F, Cirotti A, Pizzolorusso G.Anatomic variation of the abducens nerve in a single cadaver dissection: the “petrobasilar canal”.Acta Neurochir (Wien). 2017 Apr;159(4):677-680. doi:10.1007/s00701-017-3096-1

Coquet T, Lefranc M, Chenin L, Foulon P, Havet É, Peltier J.Unilateral duplicated abducens nerve coursing through both the sphenopetroclival venous gulf and cavernous sinus: a case report.Surg Radiol Anat. 2018 Jul;40(7):835-840. doi:10.1007/s00276-018-2003-7

Alkhatib RF, Chen RC, Sing BWH, Sanamandra SK.Unilateral abducens nerve avulsion injury following trauma.Singapore Med J. 2023 Nov 9. doi:10.4103/singaporemedj.SMJ-2022-222

Cedars-Sinai.Sixth Nerve Palsy.

Mehta MM, Garg RK, Rizvi I, Verma R, Goel MM, Malhotra HS,et al.The Multiple Cranial Nerve Palsies: A Prospective Observational Study.Neurol India. 2020 May-Jun;68(3):630-635. doi:10.4103/0028-3886.289003

Ganesh S, Anilkumar SE, Narendran K.Botulinum toxin A in the early treatment of sixth nerve palsy in type 2 diabetes.Indian J Ophthalmol. 2019 Jul;67(7):1133-1136. doi:10.4103/ijo.IJO_1267_18

Nam YS, Kim IB, Shin SY.Detailed anatomy of the abducens nerve in the lateral rectus muscle.Clin Anat. 2017;30(7):873–877. doi:10.1002/ca.22918

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