Benign recurrent sixth nerve palsy is a rare phenomenon, and the majority of reported cases suffer from their first episode in early childhood. In this case report, we present a benign recurrent isolated left 6th nerve palsy in a nine-year-old boy. All episodes were precipitated by an upper respiratory tract infection and resolved within 2-3 weeks. Extensive investigations with two MRI scans, two lumbar punctures and several blood tests showed no underlying cause. This diagnosis of exclusion is worth considering in an otherwise well-appearing child, especially if precipitated by febrile illness.
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