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Magnetic resonance spectroscopy showed a lipid lactate peak leading to a diagnosis of pontine tuberculoma. The diagnosis was supported by a positive Mantoux and interferon-gamma release assay. There was no other systemic focus of tuberculosis. She was then started on antitubercular therapy (ATT) for 18 months. After 8 months of ATT, a repeat MRI showed a decrease in the volume of the tuberculoma. This case exemplifies a unique case of isolated abducens palsy in the absence of features of raised intracranial tension, which could localise the lesion to the pons.<\/jats:p>","DOI":"10.1136\/bcr-2024-263879","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T02:26:46Z","timestamp":1742956006000},"page":"e263879","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Pontine tuberculoma presenting as a true-localising abducens palsy"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6060-7095","authenticated-orcid":false,"given":"Sripathi","family":"Kamath B","sequence":"first","affiliation":[{"name":"Ophthalmology, Father Muller Medical College, Mangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2622-2397","authenticated-orcid":false,"given":"Madhurima 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