Title Page Case report: Paralytic squint due to abducens nerve palsy : A rare consequence of dengue fever Authors:

Dengue fever is an endemic illness in the tropics with early and post infectious complications affecting multiple systems. Though neurological sequelae including mononeuropathy, encephalopathy, transverse myelitis, polyradiculopathy, Guillain-Barre syndrome , optic neuropathy and oculomotor neuropathy have been reported in medical literature, the abducens nerve despite its notoriety in cranial neuropathies in a multitude of condition due to its long intracranial course had not been to date reported to manifest with lateral rectus paralysis following dengue. The authors detail the first such case of abducens nerve palsy complicating dengue fever in a previously healthy male from Sri Lanka. Background Dengue virus infections are known to manifest in three main forms: — classic dengue fever (DF, dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) [1]. Morbidity and mortality can be minimized if accepted resuscitation protocols are adhered to and recovery is usually without residual disability. Neurological deficits complicating dengue fever has gained attention with the wide availability and use of diagnostic tools to diagnose dengue fever with certainty. Though mononeuropathy, encephalopathy, transverse myelitis, polyradiculopathy, Guillain-Barre syndrome, oculomotor neuropathy and optic neuropathy [2,3,4,5,6,7] have all been documented in literature to date, abducens nerve palsy has eluded clinical observation. The authors report the first case of a patient who developed a convergent paralytic squint due to right abducens palsy during the critical phase of dengue fever.