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Fourth cranial nerve palsy or trochlear nerve palsy, is a condition affecting cranial nerve 4 (IV), [1] the trochlear nerve, which is one of the cranial nerves. It causes weakness or paralysis of the superior oblique muscle that it innervates. This condition often causes vertical or near vertical double vision as the weakened muscle prevents ...
Congenital fourth cranial nerve palsy can be treated with strabismus surgery, where muscle attachment sites on the globe are modified to realign the eyes. Some eye doctors prefer conservative or no management of congenital fourth nerve palsy.
Common activities requiring this type of convergent gaze are reading the newspaper and walking down stairs. Diplopia associated with these activities may be the initial symptom of a fourth nerve palsy. Alfred Bielschowsky's head tilt test is a test for palsy of the superior oblique muscle caused by damage to cranial nerve IV (trochlear nerve).
These changes are thought to result from a microvascular injury involving small blood vessels that supply nerves (vasa nervorum). Relatively common conditions which may be associated with diabetic neuropathy include distal symmetric polyneuropathy ; third , fourth , or sixth cranial nerve palsy; [ 3 ] mononeuropathy ; mononeuropathy multiplex ...
The Parks–Bielschowsky three-step test, [1] also known as Park's three-step test or Bielschowsky head tilt test, [2] is a method used to isolate the paretic extraocular muscle, particularly superior oblique muscle and trochlear nerve (fourth cranial nerve), [3] in acquired vertical double vision. [4] It was originally described by Marshall M ...
The facial nerve is the seventh of 12 cranial nerves. This cranial nerve controls the muscles in the face. Facial nerve palsy is more abundant in older adults than in children and is said to affect 15-40 out of 100,000 people per year. This disease comes in many forms which include congenital, infectious, traumatic, neoplastic, or idiopathic.
More rarely, the oculomotor nerve and trochlear nerve (third and fourth nerve palsy, respectively) are affected; both play a role in eye movements. [7] [8] The facial nerve (seventh cranial nerve) is affected occasionally – the result is total or partial weakness of the muscles of facial expression on one or both sides of the face. [5]
Superior oblique palsy is a common complication of closed head trauma. Restriction of superior oblique relaxation movement due to an inelastic tendon is found in Brown syndrome , leading to difficulty elevating the eye in the adducted position.