A Case Report of Idiopathic Abducens Nerve Palsy with Diplopia Treated with Korean Medicine Including <i>Hyangbujasungi-san</i>

Objectives: This study aims to report the clinical effectiveness of Korean medicine, specifically the Sasang constitutional medicine approach using <i>Hyangbujasungi-san</i>, in a patient with idiopathic abducens nerve palsy presenting with horizontal diplopia and dizziness.Case Presentation: A 74-year-old woman presented with limited abduction (2 mm) of the right eye due to idiopathic abducens nerve palsy. Based on her constitutional symptoms-including hypohidrosis (reduced sweating), frequent urination, and specific changes in bowel habits-she was diagnosed as the Soeumin type with Jung-gi-jeung (Middle Qi syndrome). The patient received 12 weeks of combined Korean medicine treatment centered on the herbal prescription <i>Hyangbujasungi-san</i>, along with acupuncture and electroacupuncture. Following treatment, the abduction range of the right eye improved from 2 mm to 10 mm, and the patient reported more than 90% subjective improvement in diplopia.Conclusions: This case suggests that the Sasang constitutional medicine approach, particularly the use of <i>Hyangbujasungi-san</i>, may represent a viable therapeutic option for managing idiopathic abducens nerve palsy, providing objective improvement in ocular motility and subjective relief of diplopia.