In 26 patients (25%) the cause remained undetermined. Our study confirms the difficulty of establishing an aetiological diagnosis in patients with isolated ocular palsies.

Cranial nerve palsies and ocular motility disorders are conditions that affect eye movement and coordination, often leading to symptoms such as double vision (diplopia) and misalignment of the eyes.

while CN III and CN IV palsies are seen very rarely in MS. Other eye movement abnormalities which may occur in MS include impaired smooth pursuit, skew deviation, impaired vestibulo-ocular reflex ...