What are the types of trochlear nerve palsy (fourth nerve palsy)?

Updated: Oct 08, 2019
  • Author: Zafar A Sheik, MD, MD; Chief Editor: Andrew G Lee, MD  more...
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The fourth cranial nerve innervates superior oblique muscle, which intorts, depresses, and abducts the globe. [2] Fourth nerve palsy can be congenital or acquired, unilateral or bilateral, each of which presents with a distinct clinical picture. [3] Clinicians must carefully assess the patient to determine both etiology and extent of disease. Acquired weakness of this muscle usually leads to complaints of binocular vertical or oblique diplopia, sometimes with a torsional component. Surgery may be required to treat these patients. Thorough assessment and careful preoperative planning maximize the chances of a successful surgical outcome.

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