We present a case of isolated abducens nerve palsy with negative magnetic resonance imaging (MRI) findings and unusual cerebrospinal fluid results. The patient was treated for a central nervous system infection initially. After the second cerebrospinal fluid examination, a diagnosis of central nervous system leukemia was made. Isolated abducens nerve palsy is not always a stable or benign illness, even with a normal brain MRI study. Abnormal cerebrospinal fluid results should suggest the presence of a central nervous system malignancy. (J Child Neurol 2002;17:850—851).
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